Research informed by NCDR data was presented at HRS 2025, held April 24-27 in San Diego, CA, and SCAI 2025, held May 1-3 in Washington, DC, comparing single vs. double transeptal puncture in atrial fibrillation (AFib) ablation, outcomes of patients with prior history of gastrointestinal bleeding undergoing left atrial appendage occlusion (LAAO) and evaluating calcium modification strategies in STEMI with severely calcified lesions.

Procedural Outcomes of Single vs. Double Transeptal Puncture in Catheter Ablation For AFib
Alejandro Velasco, MD, FACC, et al., found that single transeptal puncture was associated with less overall complications (1.7% vs. 2.1%, p<0.001; odds ratio [OR] 0.90, 95% CI 0.87-0.93), shorter length of stay and higher rate of discharge in sinus rhythm when compared to double transeptal puncture. Their analysis included 212,345 patients from the ACC’s AFib Ablation Registry. Read more.

Outcomes of LAAO in Patients With and Without Gastrointestinal Bleeds
Patients with prior gastrointestinal bleeds undergoing LAAO were more likely to experience in-hospital complications (1.9% vs. 1.3%; OR 1.18, 95% CI, 1.10-1.26) and had a greater risk for long-term gastrointestinal bleeding and major bleeding. No difference was found in the risk of stroke through one year follow up. Aashish Katapadi, MD, et al. included 84,472 patients with prior gastrointestinal bleed history and 166,307 patients without from the the ACC’s LAAO Registry.Read more.

Calcium Modification Strategies in STEMIs Complicated by Severely Calcified Lesions
Although use of advanced calcium modification tools was low overall in STEMI patients with severely calcified lesions, Ajar Kochar, MD, FACC, et al., noted a marked increase in use of intravascular lithotripsy (IVL) from 2021 to 2023. Including 627,060 STEMI patients from the ACC’s CathPCI Registry, 6.7% of which had severely calcified lesions, the authors found that rotational and orbital atherectomy was associated with increased likelihood of major adverse cardiovascular events (MACE) (OR 1.33, 95% CI 1.06-1.63, p=0.01) while IVL and specialty balloons were not (OR 0.96, 95% CI 0.83-1.1; OR 0.92, 95% CI 0.79-1.06, respectively). Read more.

Interested in using NCDR data to test your own hypotheses? Visit the NCDR research proposal webpage to learn more.

Plus, share your quality improvement successes at ACC Quality Summit 2025. The ACC is currently accepting abstracts for Live Sessions and ePosters. Submission deadlines are Tuesday, May 27 and Monday, June 23, respectively. Submit your abstract today.

Clinical Topics: Arrhythmias and Clinical EP, Stable Ischemic Heart Disease, Atrial Fibrillation/Supraventricular Arrhythmias, Chronic Angina

Keywords: National Cardiovascular Data Registries, AFib Ablation Registry, LAAO Registry, CathPCI Registry, Quality Improvement, Atrial Fibrillation, Gastrointestinal Hemorrhage, ST Elevation Myocardial Infarction