{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T23:44:16Z","timestamp":1787269456798,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine trends in real\u2010world utilization and in\u2010hospital adverse events from Watchman implantation since its approval by the Food and Drug Administration in 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The risk of embolic stroke caused by atrial fibrillation is reduced by oral anticoagulants, but not all patients can tolerate long\u2010term anticoagulation. Left atrial appendage occlusion with the Watchman device has emerged as an alternative therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study utilizing data from National Inpatient Sample for calendar years 2015\u20132017. The outcomes assessed in this study were associated complications, in\u2010hospital mortality, and resource utilization trends after Watchman implantation. Trends analysis were performed using analysis of variance. Multivariable adjusted logistic regression analysis was performed to determine predictors of mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 17\u2009700 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 1195 in 2015 to 11\u2009165 devices in 2017, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). A significant decline in the rate of complications (from 26.4% in 2015% to 7.9% in 2017, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) and inpatient mortality (from 1.3% in 2015% to 0.1% in 2017, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) were noted. Predictors of in\u2010hospital mortality included a higher CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score (odds ratio [OR]: 2.61 per 1\u2010point increase, 95% confidence interval [CI]: 1.91\u20133.57), chronic blood loss anemia (OR:\u00a03.63, 95% CI: 1.37\u20139.61) and coagulopathy (OR: 4.90, 95% CI: 2.32\u201310.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In contemporary United States clinical practice, Watchman utilization has increased significantly since approval in 2015, while complications and in\u2010patient mortality have declined.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14804","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T06:44:46Z","timestamp":1604645086000},"page":"83-92","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-898X","authenticated-orcid":false,"given":"Muhammad Bilal","family":"Munir","sequence":"first","affiliation":[{"name":"Section of Electrophysiology,\u00a0Division of Cardiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Zia","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine West Virginia University Heart &amp; Vascular Institute  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Darden","sequence":"additional","affiliation":[{"name":"Section of Electrophysiology,\u00a0Division of Cardiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak K.","family":"Pasupula","sequence":"additional","affiliation":[{"name":"Division of Cardiology,\u00a0Heart and Vascular Institute University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarshan","family":"Balla","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine West Virginia University Heart &amp; Vascular Institute  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick T.","family":"Han","sequence":"additional","affiliation":[{"name":"Section of Electrophysiology,\u00a0Division of Cardiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Reeves","sequence":"additional","affiliation":[{"name":"Section of Electrophysiology,\u00a0Division of Cardiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-573X","authenticated-orcid":false,"given":"Jonathan C.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Section of Electrophysiology,\u00a0Division of Cardiology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"e38","article-title":"Heart disease and stroke statistics\u20102016 update: a report from the American Heart Association","volume":"133","author":"Mozaffarian D","year":"2016","journal-title":"Circulation"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.676551"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.248"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.013"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011139"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005451"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2015.0374"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.09.025"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61343-X"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.021"},{"key":"e_1_2_9_14_1","volume-title":"Overview of the national inpatient sample (NIS)","author":"Agency for Healthcare Research and Quality","year":"2020"},{"key":"e_1_2_9_15_1","article-title":"Incidence and causes of in\u2010hospital outcomes and 30\u2010day readmissions after percutaneous left atrial appendage closure: A US nationwide retrospective cohort study using claims data","volume":"17","author":"Vuddanda VLK","year":"2019","journal-title":"Heart Rhythm"},{"issue":"16","key":"e_1_2_9_16_1","first-page":"e66","article-title":"2019 AHA\/ACC\/HRS focused update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"2019","author":"January CT","journal-title":"Heart Rhythm"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.064"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv730"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.010"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.040"},{"key":"e_1_2_9_21_1","unstructured":"Centers for Medicare and Medicaid Services Coverage with Evidence Development (Left Atrial Appendage Occlusion).https:\/\/www.cms.gov\/Medicare\/Coverage\/Coverage-with-Evidence-Development\/LAAC. 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