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JACC Cardiovasc Interv. 2015 Aug 24;8(10):1346-55. doi: 10.1016/j.jcin.2015.06.010.

Baseline Characteristics and Prognostic Implications of Pre-Existing and New-Onset Atrial Fibrillation After Transcatheter Aortic Valve Implantation: Results From the FRANCE-2 Registry.

Author information

1
Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France. Electronic address: rchopard@chu-besancon.fr.
2
Department of Cardiology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil, Créteil, France.
3
Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France.
4
Department of Cardiovascular Surgery, EA3920, University Hospital Besançon, Besançon, France.
5
Centre Hospitalier Universitaire (CHU) de Brest, Brest, France.
6
Department of Cardiac Surgery, University Hospital Dupuytren, Limoges, France.
7
CHU de Rouen, Rouen, France.
8
Department of Cardiology, Bichat-Claude-Bernard Hospital, AP-HP, Paris, France.
9
CHU La Pitié Salpêtrière, Paris, France.
10
Unité de recherche clinique en économie de la santé Ile-de-France (URC Eco), AP-HP, Hôtel-Dieu, Paris, France.
11
Department of Cardiovascular Surgery, CHU Lille, Lille, France.
12
University Lyon 1, Lyon, France.
13
Division of Thoracic, Cardiac and Vascular Surgery, Rennes University Hospital, Rennes, France.
14
Jacques Cartier Institute, Massy, France.
15
Clinique Pasteur, Toulouse, France.

Abstract

OBJECTIVES:

The aim of this study was to determine baseline characteristics and clinical outcomes of patients with pre-existing atrial fibrillation (AF) and of patients who presented with new-onset AF after transcatheter aortic valve implantation (TAVI).

BACKGROUND:

Little is known regarding the impact of AF after TAVI.

METHODS:

The FRANCE-2 registry included all patients undergoing TAVI (N = 3,933) in France in 2010 and 2011. New-onset AF was defined as the occurrence of AF post-procedure in a patient with no documented history of AF.

RESULTS:

AF was documented before TAVI in 25.8% of patients. New-onset AF was observed in 174 patients after TAVI among patients without a history of pre-existing AF (6.0%). At 1 year, the rates of all-cause death (26.5 vs. 16.6%, respectively; p < 0.001) and cardiovascular death (11.5 vs. 7.8%, respectively; p < 0.001) were significantly higher in patients with pre-existing AF compared with those without AF. Rehospitalization for worsening heart failure and New York Heart Association functional class was also higher in patients with pre-existing AF versus those without, resulting in a higher rate of combined efficacy endpoint in this group (p < 0.001). A history of stroke, surgical (nontransfemoral) approach, cardiological, and hemorrhagic procedure-related events were all independently related to the occurrence of new-onset post-procedural AF. New-onset AF in patients without pre-existing AF was associated with a higher rate of combined safety endpoint at 30 days (p < 0.001) and a higher rate of both all-cause death and combined efficacy endpoint at 1 year (p = 0.003 and p = 0.02, respectively).

CONCLUSIONS:

Pre-existing and new-onset AF are both associated with higher mortality and morbidity after TAVI.

KEYWORDS:

aortic stenosis; atrial fibrillation; outcomes; transcatheter aortic valve implantation

PMID:
26315738
DOI:
10.1016/j.jcin.2015.06.010
[Indexed for MEDLINE]
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