Abstract 15384: Regional Trends in Watchman Device Placement in United States, Insight From National Inpatient Sample

Abstract

Introduction: Watchman Implant is a minimally invasive procedure designed to reduce the risk of strokes that originate in the left atrial appendage in patients who cannot receive anticoagulation. Recently, the device is widely adopted in United States(US). Hypothesis: Significant variability exists in watchman device implantation across US. Methods: National Inpatient sample was used from year 2015-2019. ICD9 & ICD-10 codes were used for data extraction. US population was divided into four regions. Northeast, Midwest, South and West. Mortality and major complications were adjusted for age, sex, race and standard comorbid conditions using logistic regression analysis. Major complication was composite of cardiac arrest, ischemic stroke, hemorrhagic stroke, TIA, arterial embolism, myocardial infarction, major bleeding, pericardial effusion requiring intervention and peripheral vascular complications. Results: Total of 62,980 patients were identified (Figure1). There has been gradual increase trend in watchman implants over the years. Median age was 77(71-82) yrs. Mortality was lowest in Midwest (Figure 2), while Major complications were lowest West region (Figure 3). Conclusions: Significant variability exists in outcomes across different regions of US. Further studies are needed to determine the significance of these findings.