Arrhythmias & electrophysiology
Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
Authors' conclusion
Contemporary LAAO is safe with low rates of procedural complications and no significant differences in procedural outcomes by operator subspecialty after multivariable adjustment.
Study context
- Population
- Patients undergoing Watchman FLX or Amulet Left Atrial Appendage Occlusion (LAAO), NCDR LAAO Registry, 2020–2022
- Participants
- 91,711 procedures
- Exposure
- LAAO by EP vs IC operators
- Outcome
- MAE, mortality, ischemic stroke and major bleeding
- Follow-up
- Initial hospitalization and 45 days
Methodological detailsregistry-based (NCDR LAAO Registry), multivariable Cox regression
- Registry-based (NCDR LAAO Registry)
- Multivariable Cox regression
Main finding
As reported in the abstract
In-hospital death and MAE · initial hospitalization
Death
MAE
Observational data: associations, not effects.
Further findings
Intracardiac echocardiography use
P < 0.001
Total radiation
P < 0.001
Death and major adverse event (MAE) at 45 days (multivariable regression)
- No difference in death at 45 days, HR
- 1.03 (95% CI 0.89-1.20)
- No difference in MAE at 45 days, HR
- 0.97 (95% CI 0.91-1.03)
- After multivariable regression
Discharge antithrombotic regimen
- EPs more likely to discharge on DOAC + aspirin; ICs more likely on single or dual antiplatelet therapy
- all P < 0.001
Original publication
Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion. JACC Cardiovasc Interv. Published 28 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it