Arrhythmias & electrophysiologyCohort study
Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
- Retrospective cohort study
- registry-based (NCDR left atrial appendage occlusion (LAAO) Registry)
- multivariable Cox regression
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 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
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:10.1016/j.jcin.2024.10.020
Summarised from the published abstract; every number is checked against it