Abstract 4145451: Efficacy of Left Atrial Appendage Occlusion with Watchman Device in the Population with BMI>25

Background: Left atrial appendage closure (LAAC) with Watchman device is an alternative strategy to oral anticoagulation for decreasing ischemic stroke risk in selected patients with non –valvular atrial fibrillation (AF). There is a paucity of data about the efficacy of watchman device in overweight/obese population. Methods: We queried the National Inpatient Sample of the years 2016 to 2020. We identified patients who were admitted for Watchman procedures using ICD10-PCS codes. The risk of mortality and in-hospital complications in overweight/obese group was compared to the non–overweight/non obese group using multivariate logistic regression analysis. Results: During 2016-2020, there were a total of 90060 patients who were admitted for Watchman procedure, of which 15765(17.5%) patients were overweight or obese while 74295 (82.5%) were neither obese nor overweight. After adjusting for demographics, watchman procedure in overweight/obese population had higher odds of arrhythmia (aOR (adjusted odds ratio) 1.19; 95% CI 1.08–1.31 p <0.001), AKI (aOR 1.32; 95% CI 1.03–1.68p =0.026), respiratory failure (aOR 1.52; 95% CI 1.16–1.98 p =0.02), and non-invasive ventilation (aOR 1.9; 95% CI 1.33–2.7 p<0.001). There were no differences in mortality, GI bleed, Length of stay (LOS) and mean total cost of care between the two groups. Conclusion: Left atrial appendage occlusion with Watchman device in overweight /Obese population has higher odds of arrhythmia, AKI, respiratory failure, and non –invasive ventilation compared to non-overweight/non obese population. Further studies are needed to elucidate the benefit of Watchman device in the overweight/obese population.