{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:38:04Z","timestamp":1790800684932,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Percutaneous left atrial appendage occlusion (LAAO) is an alternative to long\u2010term anticoagulation for preventing ischemic stroke in patients with atrial fibrillation. There are limited long\u2010term outcomes data for \u201creal\u2010world\u201d patients undergoing LAAO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We performed a retrospective cohort study using the National Cardiovascular Data Registry LAAO registry from January 1, 2016, through December 31, 2019. We linked LAAO data to inpatient Medicare fee\u2010for\u2010service claims data using probabilistic matching to establish a cohort of patients 65\u2009years and older undergoing LAAO with a WATCHMAN device. The primary outcomes were any stroke and all\u2010cause mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 34\u2009975 patients with a mean\u00b1SD CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc (congestive heart failure, hypertension, age \u226575\u2009years, diabetes, previous stroke or transient ischemic attack, vascular disease, age 65 to 74\u2009years, and sex category) score of 4.7\u00b11.4 were included. The median follow\u2010up was 2.8\u2009years (interquartile range, 2.2\u20133.7\u2009years). The cumulative incidence of any stroke was 1.57 per 100 person\u2010years (95% CI, 1.45\u20131.70), with a 1\u2010year and 5\u2010year any stroke estimate of 1.70% (95% CI, 1.57\u20131.84%) and 5.70% (95% CI, 5.37\u20136.05%), respectively. The cumulative incidence of ischemic stroke was 1.36 per 100 person\u2010years (95% CI, 1.25\u20131.48), with a 1\u2010year and 5\u2010year ischemic stroke estimate of 1.42% (95% CI, 1.30\u20131.54%) and 5.03% (95% CI, 4.71\u20135.36%), respectively. The cumulative incidence of death was 10.82 per 100 person\u2010years (95% CI, 10.49\u201311.13), with a 5\u2010year mortality estimate of 44.34% (95% CI, 43.35\u201345.23%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term stroke rates in a large nationally representative cohort of Medicare patients following LAAO were low and durably consistent during long\u2010term follow\u2010up despite a high thromboembolic risk. High mortality rates in this elderly population underscore the importance of incorporating patient values and preferences when considering LAAO.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039780","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:49:31Z","timestamp":1754477371000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010Term Outcomes Following Left Atrial Appendage Occlusion in Medicare Beneficiaries: Outcomes From the National Cardiovascular Data Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3265-5928","authenticated-orcid":false,"given":"Angela Y.","family":"Higgins","sequence":"first","affiliation":[{"name":"Maine Medical Center","place":["Portland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-8498","authenticated-orcid":false,"given":"Sarah","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]},{"name":"Yale New Haven Health Services Corporation","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-2213","authenticated-orcid":false,"given":"Yongfei","family":"Wang","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]},{"name":"Yale New Haven Health Services Corporation","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-1954","authenticated-orcid":false,"given":"Daniel J.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Duke University Medical Center and Duke Clinical Research Institute","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9276-9110","authenticated-orcid":false,"given":"Kamil F.","family":"Faridi","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]},{"name":"Yale New Haven Health Services Corporation","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7892-2430","authenticated-orcid":false,"given":"Matthew J.","family":"Price","sequence":"additional","affiliation":[{"name":"Scripps Clinic","place":["La Jolla, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-4993","authenticated-orcid":false,"given":"Vivek Y.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine Mount Sinai","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0037-0373","authenticated-orcid":false,"suffix":"Jr","given":"David R.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-0501","authenticated-orcid":false,"given":"Jeptha P.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]},{"name":"Yale New Haven Health Services Corporation","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4614-6879","authenticated-orcid":false,"given":"James V.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]},{"name":"Yale New Haven Health Services Corporation","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15192"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.040"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.121.008418"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.02.009"},{"key":"e_1_3_1_8_2","first-page":"714","article-title":"The WATCHMAN device and post\u2010implantation anticoagulation management. A review of key studies and the risk of device\u2010related thrombosis","volume":"11","author":"Magdi M","year":"2021","unstructured":"Magdi M, Renjithal SLM, Mubasher M, Mostafa MR, Lathwal Y, Mukuntharaj P, Mohamed S, Alweis R, Tan BE, Baibhav B. The WATCHMAN device and post\u2010implantation anticoagulation management. A review of key studies and the risk of device\u2010related thrombosis. Am J Cardiovasc Dis. 2021;11:714\u2013722.","journal-title":"Am J Cardiovasc Dis"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.02.047"},{"key":"e_1_3_1_10_2","unstructured":"Medicare Cf and Services M . 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