Left Atrial Appendage Occlusion Registry (LAAO Registry)



Status:Recruiting
Conditions:Atrial Fibrillation
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - Any
Updated:6/29/2017
Start Date:December 2015
End Date:January 2026
Contact:Mark Fox, CHC, CHPC
Email:mfox@acc.org
Phone:202-375-6305

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The Left Atrial Appendage Occlusion Registry (LAAO Registry™) is designed to assess the
prevalence, demographics, management, and outcomes of patients undergoing percutaneous and
epicardial based left atrial appendage occlusion procedures to reduce the risk of stroke.
Patient-level data will be submitted by participating hospitals on a quarterly basis to the
American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR).
The primary aims of the LAAO Registry are to optimize the outcomes and management of
patients through the implementation of evidence-based guideline recommendations in clinical
practice, facilitate efforts to improve the quality and safety for patients undergoing
percutaneous and epicardial based left atrial appendage procedures, investigate novel
quality improvement methods and provide risk-adjusted assessment of patients for comparison
with nationwide NCDR data. The secondary purpose of the LAAO Registry is to serve as a rich
source of clinical data to support assessments of short- and long-term safety, comparative
and cost effectiveness research, and as a scalable data infrastructure for post market
studies.

Hospitals join the Left Atrial Appendage Occlusion Registry (LAAO Registry) by agreeing to
the terms of a specific contract that outlines the obligations of each party and the annual
fees for participation. In addition, participating sites sign a Business Associate Agreement
with the American College of Cardiology (ACC) as per the requirements of the Health
Insurance Portability and Accountability Act of 1996 (HIPAA).

The LAAO Registry dataset, comprised of approximately 300 data elements, was created by a
panel of experts using available American College of Cardiology (ACC), Heart Rhythm Society
(HRS), and Society for Cardiovascular Angiography and Interventions (SCAI) societal overview
document guidance, data elements and definitions, previous trial data elements, and other
evidentiary sources. Protected Health Information (PHI), such as social security number, is
collected. The intent for collection of PHI is to allow for complete follow-up and tracking
of the patient, to assist data managers in correcting data collection errors and improving
data quality, for future registry interoperability and the potential for future generation
of patient-level drill downs in Quality and Outcomes Reports (see section 11, Data Analysis
and Statistical Considerations). Registry sites can opt out of transmitting direct
identifiers to the National Cardiovascular Data Registry (NCDR), so inclusion of direct
identifiers in the registry is at the discretion of the registry site. When using the NCDR
web-based data collection tool, direct identifiers are entered but a partition between the
data collection process and the data warehouse maintains the direct identifiers separate
from the analysis datasets. The minimum level of PHI transmitted to the ACC when a
participant opts out of submitting direct identifiers meets the definition of a Limited
Dataset as such term is defined by the Health Insurance Portability and Accountability Act
of 1996.

Data required for registry participation are collected retrospectively from existing medical
records or concurrently in the normal course of treatment. The Societal Document and safety
recommendations for left atrial appendage occlusion recommend additional testing and contact
with the patient outside the hospital episode of care at 45 days, 6 months, 1 year and 2
years post-procedure. All registry data (in-hospital and follow-up) is captured by
participating sites using an electronic data collection tool provided by the LAAO Registry
or in the future the option will be available for collecting data using a certified software
application that has been reviewed and certified as compliant with the transmissions
specifications established by the ACC for the LAAO Registry.

Upon completion of a call for data window, participants prepare a data submission by
exporting the data from their data collection mechanism and uploading their data to a secure
https server at the ACC using approved encryption software with the highest encryption that
is allowed.

In recognition of the importance of data quality to all of its registry products, and to
ensure that data submitted to the NCDR are complete, consistent, and accurate, a Data
Quality Program was formally established by the NCDR in 2004. Upon receipt of the LAAO
Registry data submission, the ACC reviews the data electronically and reports back coding
errors. Such electronic checks verify consistency and completeness and allow participants to
have ample opportunity to submit data until it satisfies consistency and completion
thresholds. The report produced from these data checks is called a Data Quality Report
(DQR).

The DQR provides the participant with a confidential analysis of their data submission's
completeness, and is used by the participant to help prioritize data cleaning efforts and to
assess the necessity for re-submission.

Once the data meets the data quality thresholds, an Outcomes Report is produced. The
Outcomes Report aggregates the participant's data and provides a comparison group (usually
procedure volume based) and national comparison.

The NCDR understands the need to ensure the data submitted to the LAAO Registry is accurate
and it has launched a national on-site and off-site audit program whereas a random set of
participants participate in an on-site or off-site audit to confirm the data submitted to
the registry is consistent with data in the medical record or source documentation.

Inclusion Criteria:

- Adult patients, 18 years and older, undergoing percutaneous or epicardial left atrial
appendage occlusion procedures

Exclusion Criteria:
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