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  1. Article ; Online: NCDR Left Atrial Appendage Occlusion Registry: The "Watch" Man Has Arrived.

    Lakkireddy, Dhanunjaya R / Turagam, Mohit K

    Journal of the American College of Cardiology

    2020  Volume 75, Issue 13, Page(s) 1519–1522

    MeSH term(s) Atrial Appendage/diagnostic imaging ; Atrial Appendage/surgery ; Atrial Fibrillation/epidemiology ; Humans ; Male ; Registries ; Warfarin
    Chemical Substances Warfarin (5Q7ZVV76EI)
    Language English
    Publishing date 2020-04-01
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2020.01.007
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    Zs.A 1846: Show issues Location:
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  2. Article ; Online: Amulet Occluder Implantation in Patients With Failed Prior Left Atrial Appendage Occlusion: EMERGE LAA Insights.

    Alkhouli, Mohamad / Makkar, Akash / Freeman, James V / Ellis, Christopher R / Shah, Atman P / Gada, Hemal / Coylewright, Megan / Lo, Monica / Agarwal, Himanshu / Lakkireddy, Dhanunjaya

    JACC. Cardiovascular interventions

    2024  Volume 17, Issue 3, Page(s) 457–459

    MeSH term(s) Humans ; Atrial Appendage/diagnostic imaging ; Treatment Outcome ; Vascular Diseases ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/therapy ; Septal Occluder Device ; Cardiac Catheterization/adverse effects ; Echocardiography, Transesophageal ; Stroke
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Letter
    ZDB-ID 2452157-7
    ISSN 1876-7605 ; 1936-8798
    ISSN (online) 1876-7605
    ISSN 1936-8798
    DOI 10.1016/j.jcin.2023.12.012
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  3. Article ; Online: Peridevice Leak After Left Atrial Appendage Occlusion: Incidence, Mechanisms, Clinical Impact, and Management.

    Alkhouli, Mohamad / De Backer, Ole / Ellis, Christopher R / Nielsen-Kudsk, Jens Erik / Sievert, Horst / Natale, Andrea / Lakkireddy, Dhanunjaya / Holmes, David R

    JACC. Cardiovascular interventions

    2023  Volume 16, Issue 6, Page(s) 627–642

    Abstract: Left atrial appendage occlusion is an increasingly adopted stroke prevention strategy in patients with atrial fibrillation. However, peridevice leaks after the procedure are not infrequent and have recently been shown to confer a higher risk for ... ...

    Abstract Left atrial appendage occlusion is an increasingly adopted stroke prevention strategy in patients with atrial fibrillation. However, peridevice leaks after the procedure are not infrequent and have recently been shown to confer a higher risk for subsequent ischemic events. In this paper, the authors review the available research on the frequency, mechanisms, clinical significance, and management of peridevice leak after percutaneous left atrial appendage occlusion.
    MeSH term(s) Humans ; Incidence ; Atrial Appendage/diagnostic imaging ; Treatment Outcome ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Cardiac Catheterization/adverse effects
    Language English
    Publishing date 2023-03-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2452157-7
    ISSN 1876-7605 ; 1936-8798
    ISSN (online) 1876-7605
    ISSN 1936-8798
    DOI 10.1016/j.jcin.2022.12.006
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  4. Article ; Online: Left Atrial Appendage: What Do We Know? What Do We Need? Where Are We Going?

    Lakkireddy, Dhanunjaya / Holmes, David R / Kar, Saibal

    Cardiac electrophysiology clinics

    2019  Volume 12, Issue 1, Page(s) xv

    MeSH term(s) Atrial Appendage ; Atrial Fibrillation ; Humans ; Stroke/prevention & control
    Language English
    Publishing date 2019-12-25
    Publishing country United States
    Document type Editorial
    ISSN 1877-9190
    ISSN (online) 1877-9190
    DOI 10.1016/j.ccep.2019.12.001
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  5. Article: Changes in fibrinolytic activity and coagulation factors after epicardial left atrial appendage closure in patients with atrial fibrillation.

    Litwinowicz, Radoslaw / Natorska, Joanna / Zabczyk, Michal / Kapelak, Boguslaw / Lakkireddy, Dhanunjaya / Vuddanda, Venkat / Bartus, Krzysztof

    Journal of thoracic disease

    2022  Volume 14, Issue 11, Page(s) 4226–4235

    Abstract: ... susceptibility to lysis (r=-0.67, P=0.013). CLT was reduced by 10.3% (P=0.0020), plasminogen activator inhibitor ...

    Abstract Background: The left atrial appendage (LAA) is known to be the primary source of thrombus formation in atrial fibrillation (AF). We investigate whether epicardial LAA occlusion (LAAO) from the cardiovascular system has an effect on coagulation and prothrombotic status in AF.
    Methods: Twenty-two patients with nonvalvular AF, who were not currently receiving oral anticoagulation (OAC) therapy, participated in a single-center prospective study. We measured fibrinogen and plasminogen levels along with plasma fibrin clot permeability, clot lysis time (CLT) and endogenous thrombin potential (ETP) before the LAAO procedure, at discharge and 1 month afterward.
    Results: One month after the LAAO procedure, plasma fibrin clot permeability improved by 39.3% as measured by clots prepared from peripheral blood (P=0.019) and also after adjustment for fibrinogen (P=0.027). Higher plasma fibrin clot permeability was associated with improved clot susceptibility to lysis (r=-0.67, P=0.013). CLT was reduced by 10.3% (P=0.0020), plasminogen activator inhibitor-1 antigen levels were reduced by 52% (P=0.023) and plasminogen activity was increased by 8.9% (P=0.0077). A trend toward decreased thrombin generation, reflected by a decreased ETP and peak thrombin generated was also observed 1 month after LAAO procedure (P=0.072 and P=0.087, respectively). No differences were observed in tissue-type plasminogen activator and thrombin-activatable fibrinolysis inhibitor plasma levels (both P>0.05).
    Conclusions: Obtained results seem to confirm that LAA plays a key role in thrombogenesis. Elimination of LAA from the circulatory system may improve fibrin clot permeability and susceptibility to fibrinolysis in peripheral blood.
    Language English
    Publishing date 2022-10-25
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-21-1093
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  6. Article ; Online: The Zero Calcium Score Paradox.

    Ghazal, Rachad / Bawa, Danish / Ahmed, Adnan / Lakkireddy, Dhanunjaya / Singh, Vasvi

    JACC. Case reports

    2024  Volume 29, Issue 5, Page(s) 102233

    Abstract: Our study presents a case of angina with a zero calcium score yet severe coronary stenosis from noncalcified plaque. We highlight the limitation of otherwise prognostically powerful coronary calcium score as a singular predictive tool especially when ... ...

    Abstract Our study presents a case of angina with a zero calcium score yet severe coronary stenosis from noncalcified plaque. We highlight the limitation of otherwise prognostically powerful coronary calcium score as a singular predictive tool especially when used in symptomatic patients.
    Language English
    Publishing date 2024-02-05
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2024.102233
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  7. Article ; Online: First Experience With Amulet in the United States: Early Insights From EMERGE LAA Postapproval Study.

    Alkhouli, Mohamad / Freeman, James V / Ellis, Christopher R / Shah, Atman P / Gada, Hemal / Coylewright, Megan / Lo, Monica / Makkar, Akash / Agarwal, Himanshu / Lakkireddy, Dhanunjaya

    JACC. Cardiovascular interventions

    2024  

    Abstract: Background: The Food and Drug Administration approved the Amulet occluder (Abbott) after demonstrating safety and effectiveness in the Amulet IDE (AMPLATZER Amulet LAA Occluder) trial.: Objectives: The aim of the EMERGE Left Atrial Appendage study is ...

    Abstract Background: The Food and Drug Administration approved the Amulet occluder (Abbott) after demonstrating safety and effectiveness in the Amulet IDE (AMPLATZER Amulet LAA Occluder) trial.
    Objectives: The aim of the EMERGE Left Atrial Appendage study is to evaluate early postapproval outcomes of the Amulet occluder in the United States using data from the National Cardiovascular Data Registry Left Atrial Appendage Occlusion Registry.
    Methods: Patients with a commercial Amulet occluder implant attempt between Food and Drug Administration approval (August 14, 2021) and December 31, 2022, were included. The safety composite endpoint included all-cause death, ischemic stroke, systemic embolism, or device/procedure-related events requiring open cardiac surgery or endovascular intervention between device implantation and 7 days or hospital discharge (whichever is later). Major adverse events through 45 days were also reported and stratified by operator experience (early [<10 cases], moderate [10-29 cases], and high [30+ cases]).
    Results: A total of 5,499 patients underwent attempted Amulet occluder implantation. Implant success was 95.8%, and complete closure was 97.2% post-left atrial appendage occlusion and 87.1% at 45 days. A safety composite endpoint event occurred in 0.76% patients. Any major adverse event occurred in 2.9% and 5.7% of patients in-hospital and through 45 days, respectively, driven by major bleeding and pericardial effusion (PE) requiring intervention. PE requiring surgery or percutaneous intervention decreased significantly with increasing experience both in-hospital (early vs high operator experience 1.8% vs 1.1%; P = 0.006) and at 45 days (2.3% vs 1.5%; P = 0.012).
    Conclusions: The EMERGE Left Atrial Appendage study demonstrates favorable safety and effectiveness of the Amulet occluder in the real-world setting. More experienced operators had improved implant success and fewer PEs, suggesting a learning curve effect implanting this dual occlusive mechanism device.
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2452157-7
    ISSN 1876-7605 ; 1936-8798
    ISSN (online) 1876-7605
    ISSN 1936-8798
    DOI 10.1016/j.jcin.2023.11.027
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  8. Article ; Online: Atrial Fibrillation can adversely impact Heart Failure with Preserved Ejection Fraction by its association with Heart Failure Progression and Mortality: A Post-Hoc Propensity Score-Matched Analysis of the TOPCAT Americas Trial.

    Saksena, Sanjeev / Slee, April / Natale, Andrea / Lakkireddy, Dhanunjaya R / Shah, Dipen / Di Biase, Luigi / Lewalter, Thorsten / Nagarakanti, Rangadham / Santangeli, Pasquale

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2023  Volume 25, Issue 5

    Abstract: Aims: Prevalent atrial fibrillation (AF) is associated with excess cardiovascular (CV) death (D) and hospitalizations (H) in heart failure (HF) with preserved ejection fraction (pEF). We evaluated if it had an independent role in excess CVD in HFpEF and ...

    Abstract Aims: Prevalent atrial fibrillation (AF) is associated with excess cardiovascular (CV) death (D) and hospitalizations (H) in heart failure (HF) with preserved ejection fraction (pEF). We evaluated if it had an independent role in excess CVD in HFpEF and studied its impact on cause-specific mortality and HF morbidity.
    Methods and results: We used propensity score-matched (PSM) cohorts from the TOPCAT Americas trial to account for confounding by other co-morbidities. Two prevalent AF presentations at study entry were compared: (i) subjects with Any AF event by history or on electrocardiogram (ECG) with PSM subjects without an AF event and (ii) subjects in AF on ECG with PSM subjects in sinus rhythm. We analyzed cause-specific modes of death and HF morbidity during a mean follow-up period of 2.9 years. A total of 584 subjects with Any AF event and 418 subjects in AF on ECG were matched. Any AF was associated with increased CVH [hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.11-1.61, P = 0.003], HFH (HR 1.44, 95% CI 1.12-1.86, P = 0.004), pump failure death (PFD) (HR 1.95, 95% CI 1.05-3.62, P = 0.035), and HF progression from New York Heart Association (NYHA) classes I/II to III/IV (HR 1.30, 95% CI 1.04-1.62, P = 0.02). Atrial fibrillation on ECG was associated with increased risk of CVD (HR 1.46, 95% CI 1.02-2.09, P = 0.039), PFD (HR 2.21, 95% CI 1.11-4.40, P = 0.024), and CVH and HFH (HR 1.37, 95% CI 1.09-1.72, P = 0.006 and HR 1.65, 95% CI 1.22-2.23, P = 0.001, respectively). Atrial fibrillation was not associated with risk of sudden death. Both Any AF and AF on ECG cohorts were associated with PFD in NYHA class III/IV HF.
    Conclusion: Prevalent AF can be an independent risk factor for adverse CV outcomes by its selective association with worsening HF, HFH, and PFD in HFpEF. Prevalent AF was not associated with excess sudden death risk in HFpEF. Atrial fibrillation was also associated with HF progression in early symptomatic HFpEF and PFD in advanced HFpEF.
    Trial registration: TOPCAT trial is registered at www.clinicaltrials.gov:identifier NCT00094302.
    MeSH term(s) Humans ; Atrial Fibrillation/epidemiology ; Heart Failure ; Stroke Volume/physiology ; Propensity Score ; Comorbidity ; Prognosis
    Language English
    Publishing date 2023-04-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euad095
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  9. Article ; Online: Left Atrial Appendage Occlusion During Cardiac Surgery: A 75-Year-Old Journey.

    Kabra, Rajesh / Gopinathannair, Rakesh / Lakkireddy, Dhanunjaya

    Journal of the American Heart Association

    2023  Volume 12, Issue 10, Page(s) e030127

    MeSH term(s) Humans ; Aged ; Atrial Appendage/diagnostic imaging ; Atrial Appendage/surgery ; Stroke ; Cardiac Surgical Procedures/adverse effects ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Treatment Outcome ; Anticoagulants ; Cardiac Catheterization
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-05-15
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.030127
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  10. Article ; Online: Impact of reductions in Medicare reimbursement for cardiac ablation in the United States: Heart Rhythm Society's follow-up survey.

    Morin, Daniel P / Cheung, Jim W / Chung, Mina K / Garg, Jalaj / Krahn, Andrew D / Lakkireddy, Dhanunjaya R / Miller, Lisa / Rajagopalan, Bharath / Shanker, Amit J / Smith, Anne Marie / Liu, Christopher F

    Heart rhythm

    2023  Volume 20, Issue 5, Page(s) 656–657

    MeSH term(s) Aged ; Humans ; United States ; Follow-Up Studies ; Medicare ; Atrial Fibrillation/surgery ; Heart Conduction System/surgery ; Catheter Ablation ; Treatment Outcome
    Language English
    Publishing date 2023-03-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2023.03.018
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