Abstract
BACKGROUNDLeft atrial appendage occlusion has shown promise in mitigating the risk of stroke in selected patients with atrial fibrillation.OBJECTIVEThe purpose of this study was to determine the real-world prevalence and in-hospital outcomes in left atrial appendage occlusion (Watchman) recipients complicated by pericardial effusion requiring percutaneous drainage or open cardiac surgery–based intervention.METHODSData were derived from the National Inpatient Sample database from January 2015 to December 2017. The primary outcomes assessed were the prevalence of pericardial effusion requiring intervention and in-hospital outcomes including mortality, other major complications, hospital stay > 1 day, and hospitalization costs. Predictors of pericardial effusion requiring intervention were also analyzed.RESULTSPericardial effusion requiring intervention occurred in 220 total patients (1.24%). After multivariable adjustment, pericardial effusion requiring intervention was associated with in-hospital mortality (adjusted odds ratio [aOR] 511.6; 95% confidence interval [CI] 122–2145.3), other Watchman-related major complications (aOR 1.35; 95% CI 0.83–2.19), length of stay > 1 day (aOR 17.64; 95% CI 12.56–24.77), and hospitalization cost above the median of $24,327 (aOR 3.58; 95% CI 2.61–4.91). Independent patient predictors of pericardial effusion requiring intervention from the procedure included advanced age (aOR 1.029 per 1-year increase; 95% CI 1.009–1.05 per 1-year increase), higher CHA2DS2VASc score (aOR 1.221 per 1-point increase; 95% CI 1.083–1.377 per 1-point increase), and obesity (aOR 2.033; 95% CI 1.464–2.823).CONCLUSIONIn a large, contemporary real-world cohort of Watchman recipients in US practice, the prevalence of pericardial effusion requiring intervention was 1.24%. Pericardial effusion requiring intervention was associated with several adverse events including increased in-hospital mortality, other major complications, prolonged hospital stay, and hospitalization costs.
Highlights
Atrial fibrillation (AF) is an important cause of cardioembolic stroke as it results in thrombus formation in the left atrial appendage (LAA) in .90% of patients.[1]
Pericardial effusion requiring intervention was associated with in-hospital mortality, other Watchman-related major complications, length of stay . 1 day, and hospitalization cost above the median of $24,327
Pericardial effusion requiring intervention was associated with several adverse events including increased in-hospital mortality, other major complications, prolonged hospital stay, and hospitalization costs
Summary
Atrial fibrillation (AF) is an important cause of cardioembolic stroke as it results in thrombus formation in the left atrial appendage (LAA) in .90% of patients.[1] coumadin and direct oral anticoagulants are effective in reducing. AF-associated stroke risk, their use is limited by patient compliance and adverse effects.[2,3,4] LAA occlusion using a Watchman device (Boston Scientific, MA) has shown. Left atrial appendage occlusion has shown promise in mitigating the risk of stroke in selected patients with atrial fibrillation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
