{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:33:38Z","timestamp":1792794818956,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,2,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The PINNACLE FLX (Protection Against Embolism for Non\u2010valvular AF [Atrial Fibrillation] Patients: Investigational Device Evaluation of the Watchman FLX LAA [Left Atrial Appendage] Closure Technology) trial evaluated the safety and efficacy of a next\u2010generation left atrial appendage closure device (WATCHMAN FLX; Boston Scientific, Marlborough, MA). At 1\u2009year, the study met the primary end points of safety and anatomical efficacy\/appendage closure. This final report of the PINNACLE FLX trial includes the prespecified secondary end point of ischemic stroke or systemic embolism at 2\u2009years, also making it the first report of 2\u2010year outcomes with this next\u2010generation left atrial appendage closure device.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients with nonvalvular atrial fibrillation with CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc score \u22652 (men) or \u22653 (women), with an appropriate rationale for left atrial appendage closure, were enrolled to receive the left atrial appendage closure device at 29 US centers. Adverse events were assessed by an independent clinical events committee, and imaging was assessed by independent core laboratories. Among 395 implanted patients (36% women; mean age, 74\u2009years; CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc, 4.2\u00b11.5), the secondary efficacy end point of 2\u2010year ischemic stroke or systemic embolism was met, with an absolute rate of 3.4% (annualized rate, 1.7%) and an upper 1\u2010sided 95% confidence bound of 5.3%, which was superior to the 8.7% performance goal. Two\u2010year rates of adverse events were as follows: 9.3% all\u2010cause mortality, 5.5% cardiovascular death, 3.4% all stroke, and 10.1% major bleeding (Bleeding Academic Research Consortium 3 or 5). There were no additional systemic embolisms, device embolizations, pericardial effusions, or symptomatic device\u2010related thrombi after 1\u2009year.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The secondary end point of 2\u2010year stroke or systemic embolism was met at 3.4%. In these final results of the PINNACLE FLX trial, the next\u2010generation WATCHMAN FLX device demonstrated favorable safety and efficacy outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026295","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T12:16:51Z","timestamp":1676981811000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Two\u2010Year Outcomes With a Next\u2010Generation Left Atrial Appendage Device: Final Results of the PINNACLE FLX Trial"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-0211","authenticated-orcid":false,"given":"Shephal K.","family":"Doshi","sequence":"first","affiliation":[{"name":"Providence, Saint Johns Health Center Pacific Heart Institute Santa Monica 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