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

作者：Zweiker David^*; Froeschl Mario; Tiede Stephanie; Weidinger Paul; Schmid Johannes; Manninger Martin; Brussee Helmut; Zweiker Robert; Binder Josepha; Maechler Heinrich; Marte Wolfgang; Maier Robert; Luha Olev; Schmidt Albrecht; Scherr Daniel

来源：Journal of Electrocardiology, 2017, 50(4): 402-409.

DOI：10.1016/j.jelectrocard.2017.02.013

• Atrial fibrillation
• Transcatheter aortic valve implantation
• New-onset AF
• Retrospective study
• One-year mortality

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 (is = 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.

• 出版日期2017-8