New-Onset Atrial Fibrillation After Transcatheter Aortic Valve Replacement

Tj, Ryan; Grindal, Alexander W.; Jinah, Rehman; Um, Kevin J.; Vadakken, Maria E.; Pandey, A. Shekhar; Jaffer, Iqbal H.; Healey, Jeff S.; Belley‐Côté, Emilie P.; McIntyre, William F.

doi:10.1016/j.jcin.2022.01.018

Cited by 20 publications

(9 citation statements)

References 20 publications

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“…34,35 Similarly, aggressive treatment of residual cardiac conditions, such as persistent mitral or tricuspid regurgitation, systolic dysfunction, and atrial fibrillation, should be performed if the full benefit of AVR is to be reached. [36][37][38] STUDY LIMITATIONS. First, it has been demonstrated that regression of some cardiac abnormalities, such as LV mass, can take up to 5 years after AVR.…”

Section: Généreux Et Almentioning

confidence: 99%

Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement

Généreux

Redfors

Bax

et al. 2022

Journal of the American College of Cardiology

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Section: Généreux Et Almentioning

confidence: 99%

Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement

Généreux

Redfors

Bax

et al. 2022

Journal of the American College of Cardiology

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“…12 56 Journal of Cardiovascular Medicine 2024, Vol 25 No 1 Ryan et al in a meta-analysis of 179 studies showed that new-onset atrial fibrillation was associated with a near doubling of 30-day or in-hospital mortality after TAVI (RR 1.76, 95% CI 1.12-2.76). 28 The relationship between increased mortality and AF is not clear but surely multifactorial, and includes hemodynamic and functional impairment, thrombo-embolic and bleeding events, and higher rates of renal failure. 29 In 30 The interest in the study of the link between mortality and AF in the follow-up of TAVI patients could be seen also in more recent evaluation such as the one conducted by Baz et al They proposed a score which included, in addition to biohumoral and functional parameters, AF as the only clinical characteristic, remarking on its prognostic value.…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation before and after transcatheter aortic valve implantation: short- and long-term clinical implications

Arrotti,

Sgura,

Leo

et al. 2023

Journal of Cardiovascular Medicine

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Background Patients with atrial fibrillation (AF) undergoing transcatheter aortic valve implantation (TAVI) have been associated with worse short-term outcomes compared with patients in sinus rhythm but data on long-term outcomes are limited. The aim of our study was to evaluate the association between AF and short- and long-term outcomes in patients undergoing TAVI. Methods We retrospectively evaluated patients undergoing TAVI between 2012 and 2022 in four tertiary centres. Two different analyses were conducted: (i) in-hospital and (ii) postdischarge analysis. First, we evaluated the association between preexisting AF and short-term outcomes according to VARC-3 criteria. Second, we analyzed the association between AF at discharge (defined as both preexisting and new-onset AF occurring after TAVI) and long-term outcomes at median follow-up of 3.2 years (i.e. all-cause death, hospitalization and major adverse cardiovascular events). Results A total of 759 patients were initially categorized according to the presence of preexisting AF (241 vs. 518 patients). The preexisting AF group had a higher occurrence of acute kidney injury [odds ratio (OR) 1.65; 95%confidence interval ( CI) 1.15–2.38] and major bleeding (OR 1.86, 95% CI 1.06–3.27). Subsequently, the population was categorized according to the presence of AF at discharge. At the adjusted Cox regression analysis, AF was independently associated with an increased risk of all-cause death and cardiovascular hospitalization [adjusted hazard ratio (aHR) 1.42, 95% CI 1.09–1.86], all-cause death and all-cause hospitalization (aHR 1.38, 95% CI 1.06–1.78) and all-cause hospitalization (aHR 1.59, 95% CI 1.14.2.22). Conclusions In a real-world cohort of patients undergoing TAVI, the presence of AF (preexisting and new-onset) was independently associated with both short- and long-term adverse outcomes.

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“…Moreover, the lack of data on new‐onset atrial fibrillation, which may contribute to the occurrence of stroke at follow‐up, is a limitation of the present analysis. Indeed, a previous study reported new‐onset atrial fibrillation in 9.9% of patients after TAVR 31 …”

Section: Limitationsmentioning

confidence: 99%

“…Indeed, a previous study reported new-onset atrial fibrillation in 9.9% of patients after TAVR. 31 Third, data on calcium quantification through computed tomography analysis was inconsistent among centers to provide evidence regarding its correlation with stroke; this aspect, if further investigated, could potentially be of great interest for future studies.…”

Section: Limitationsmentioning

confidence: 99%

Incidence and predictors of 30‐day and 6‐month stroke after TAVR: Insights from the multicenter OBSERVANT II study

Gorla,

Tua,

D'Errigo

et al. 2023

Cathet Cardio Intervent

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BackgroundThe incidence and predictors of 30‐day stroke after transcatheter aortic valve replacement (TAVR) were derived from early studies investigating first‐generation devices. The incidence of 6‐month stroke and its related predictors are unknown.AimsTo investigate the incidence and to identify procedural and patient‐related predictors of 30‐day and 6‐month stroke after TAVR.MethodsData from 2753 consecutive patients with severe aortic stenosis undergoing TAVR were obtained from the OBSERVANT‐II study, an observational, prospective, multicenter cohort study. The study endpoints were symptomatic 30‐day and 6‐month stroke after TAVR.ResultsThe occurrence of a 30‐day and 6‐month stroke was low (1.3% and 2.4%, respectively) but with significant impact on survival. Aortic valve predilatation (odds ratio [OR]: 2.28, 95% confidence interval [CI]: 1.12–4.65, p = 0.023), diabetes (OR: 3.10, 95% CI: 1.56–6.18, p = 0.001), and left ventricle ejection fraction < 50% (OR: 2.15, 95% CI: 1.04–4.47, p = 0.04) were independent predictors of 30‐day stroke, whereas diabetes (sub‐distribution hazard ratio [SHR]: 2.07, 95% CI: 1.25–3.42, p = 0.004), pre‐existing neurological dysfunction (SHR: 3.92, 95% CI: 1.54–10, p = 0.004), bicuspid valve (SHR: 4.75, 95% CI: 1.44–15.7, p = 0.011), and critical status (SHR: 3.05, 95% CI: 1.21–7.72, p = 0.018) were predictive of 6‐month stroke. Conversely, antiplatelet therapy and anticoagulation were protective factors at both 30 days and 6 months.ConclusionsStroke after TAVR was rare. Predilatation was the only procedural factor predictive of 30‐day stroke, whereas the remaining were patient‐related risk factors, suggesting appropriate risk stratification preoperatively.

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New-Onset Atrial Fibrillation After Transcatheter Aortic Valve Replacement

Cited by 20 publications

References 20 publications

Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement

Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement

Atrial fibrillation before and after transcatheter aortic valve implantation: short- and long-term clinical implications

Incidence and predictors of 30‐day and 6‐month stroke after TAVR: Insights from the multicenter OBSERVANT II study

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