Atrial fibrillation in transcatheter aortic valve implantation patients: Incidence, outcome and predictors of new onset

J Electrocardiol. 2017 Jul-Aug;50(4):402-409. doi: 10.1016/j.jelectrocard.2017.02.013. Epub 2017 Feb 20.

Abstract

Background: There is controversial evidence if atrial fibrillation (AF) alters outcome after transcatheter aortic valve implantation (TAVI). TAVI itself may promote new-onset AF (NOAF).

Methods: We performed a single-center study including 398 consecutive patients undergoing TAVI. Before TAVI, patients were divided into a sinus rhythm (SR) group (n=226, 57%) and baseline AF group (n=172, 43%) according to clinical records and electrocardiograms. Furthermore, incidence and predictors of NOAF were recorded.

Results: Baseline AF patients had a significantly higher 1-year mortality than the baseline SR group (19.8% vs. 11.5%, p=0.02). NOAF occurred in 7.1% of patients with prior SR. Previous valve surgery was the only significant predictor of NOAF (HR 5.86 [1.04-32.94], p<0.05). NOAF was associated with higher rehospitalization rate (62.5 vs. 34.8%, p=0.04), whereas mortality was unaffected.

Conclusions: This study shows that NOAF is associated with higher rates of rehospitalization but not mortality after TAVI. Overall, patients with pre-existing AF have higher mortality.

Keywords: Atrial fibrillation; New-onset AF; One-year mortality; Retrospective study; Transcatheter aortic valve implantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / mortality
  • Austria / epidemiology
  • Electrocardiography
  • Female
  • Humans
  • Incidence
  • Male
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / mortality
  • Risk Factors
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome