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AF before TAVR linked with poorer outcomes
Among patients undergoing transcatheter aortic valve replacement, prior atrial fibrillation was associated with a nearly threefold increase in risk for adverse outcomes, according to recent findings.
The researchers aimed to evaluate the extent to which AF impacts procedural outcomes in TAVR in a cohort of 137 patients with severe aortic stenosis.
Eligible participants underwent the procedure using the Sapien transcatheter valve (Edwards Lifesciences).
The researchers assessed factors that predicted new-onset AF, including post-procedural outcomes and adverse events with a focus on the presence or absence of previous or post-procedural AF.
Forty-nine percent of the cohort demonstrated AF before TAVR. New-onset AF was reported in 21% of patients after TAVR. The cumulative incidence of post-procedural AF was 60%, according to the results.
Half of the episodes of new-onset AF occurred within 24 hours of TAVR.
New-onset AF occurred more frequently among patients who underwent transapical TAVR (adjusted OR=5.05; 95% CI, 1.40-18.20).
Patients with prior AF were significantly more likely to experience the composite outcome of all-cause death, stroke, vascular complications and repeat hospitalizations at 1 month than patients who did not previously have AF (adjusted OR=2.60; 95% CI, 1.22-5.54).
Patients who experienced AF after TAVR stayed in the ICU an average of 70 hours longer than patients without AF (95% CI, 25-114.7). Patients with AF also stayed in the hospital longer, with an increased duration of 6.7 days (95% CI, 4.69-8.73).
Disclosure: The researchers report financial disclosures with Astellas/Cardiome, Biosense Webster, Biotronik, Boston Scientific, Bristol-Myers Squibb, Cardiofocus, CardioInsight, Edwards Lifesciences, InfoBionic-Scientific, Mast Therapeutics, Medtronic, Pfizer, Portola, Sanofi, Sorin, St. Jude Medical, Thrasos, Voyage Medical and World Care Clinical.