Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States: insight from the National Inpatient Sample

Abstract

Abstract Background/Introduction Left atrial appendage occlusion with the Watchman device has emerged as a viable therapy for stroke risk mitigation in atrial fibrillation (AF) patients. Purpose To determine trends in real-world utilization and in-hospital adverse events from Watchman implantation since its approval by the Food and Drug Administration (FDA) in 2015. Methods This was a retrospective cohort study utilizing data from National Inpatient Sample for calendar years 2015–2017. Watchman procedures were identified using ICD-9-CM and ICD-10-CM codes of 37.90 and 02L73DK, respectively. The outcomes assessed were associated complications and in-hospital mortality. Trends analysis were performed using analysis of variance. Results A total of 17,700 patients underwent Watchman implantation during the study period. There was a significantly increased trend in the number of Watchman procedures performed over the study years (from 1,195 in 2015 to 11,165 devices in 2017, p<0.01). A significant decline in the rate of complications (from 26.4% in 2015 to 7.9% in 2017, p<0.01) and inpatient mortality (from 1.3% in 2015 to 0.1% in 2017, p<0.01) were noted. Conclusion Since its introduction, the Watchman procedure appears to be increasingly more common and safe in the management of stroke risk in patients with AF. Trends in mortality over years Funding Acknowledgement Type of funding source: None