PMID- 29275399
OWN - NLM
STAT- MEDLINE
DCOM- 20190131
LR  - 20190131
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 104
IP  - 14
DP  - 2018 Jul
TI  - New-onset arrhythmias following transcatheter aortic valve implantation: a
      systematic review and meta-analysis.
PG  - 1208-1215
LID - 10.1136/heartjnl-2017-312310 [doi]
AB  - OBJECTIVE: To evaluate the prevalence and clinical impact of new-onset
      arrhythmias in patients following transcatheter aortic valve implantation (TAVI).
      METHOD: We systematically identified studies reporting new-onset arrhythmias
      after TAVI other than atrioventricular conduction disturbances. We summarised
      monitoring strategies, type and prevalence of arrhythmias and estimated their
      effect on risk of death or cerebrovascular events by using random-effects
      meta-analysis. The study is registered withInternational prospective register of 
      systematic reviews (PROSPERO) (CRD42017058053). RESULTS: Sixty-five studies (43
      506 patients) reported new-onset arrhythmias following TAVI. The method of
      arrhythmia detection was specified only in 31 studies (48%). New-onset atrial
      fibrillation (NOAF) (2641 patients), bradyarrhythmias (182 patients),
      supraventricular arrhythmias (29 patients), ventricular arrhythmias (28 patients)
      and non-specified major arrhythmias (855 patients) were reported. In most studies
      (52 out of 65), new-onset arrhythmia detection was limited to the first month
      following TAVI. The most frequently documented arrhythmia was NOAF with trend of 
      increasing summary prevalence of 11%, 14%, 14% and 25% during inhospital, 30-day,
      1-year and 2-year follow-ups, respectively (P for trend=0.011). Summary
      prevalence estimates of NOAF at 30-day follow-up differ significantly between
      studies of prospective and retrospective design (8% and 21%, respectively,
      P=0.002). New episodes of bradyarrhythmias were documented with a summary crude
      prevalence of 4% at 1-year follow-up. NOAF increased the risk of death (relative 
      risk 1.61, 95% CI 1.35 to 1.98, I(2)=47%) and cerebrovascular events (1.79, 95%
      CI 1.24 to 2.64, I(2)=0%). No study commented on therapeutic modifications
      following the detection of new-onset arrhythmias. CONCLUSIONS: Systematic
      identification of new-onset arrhythmias following TAVI may have considerable
      impact on subsequent therapeutic management and long-term prognosis in this
      patient population.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text
      of the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Siontis, George C M
AU  - Siontis GCM
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Praz, Fabien
AU  - Praz F
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Lanz, Jonas
AU  - Lanz J
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Vollenbroich, Rene
AU  - Vollenbroich R
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Roten, Laurent
AU  - Roten L
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Stortecky, Stefan
AU  - Stortecky S
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Raber, Lorenz
AU  - Raber L
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Windecker, Stephan
AU  - Windecker S
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
FAU - Pilgrim, Thomas
AU  - Pilgrim T
AD  - Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern,
      Bern, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20171223
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - AIM
SB  - IM
MH  - Arrhythmias, Cardiac/*etiology/mortality
MH  - Cerebrovascular Disorders/etiology
MH  - Humans
MH  - Postoperative Complications
MH  - Prevalence
MH  - Transcatheter Aortic Valve Replacement/*adverse effects
OTO - NOTNLM
OT  - *aortic stenosis
OT  - *atrial fibrillation
OT  - *bradyarrhythmias
OT  - *meta-analysis
OT  - *transcatheter valve interventions
COIS- Competing interests: FP is a consultant for Edwards Lifesciences. SW has received
      research grants to the institution from Bracco, Boston Scientific and Terumo,
      outside the submitted work. TP received research grants to the institution from
      Edwards Lifesciences, Symetis and Biotronik.
EDAT- 2017/12/25 06:00
MHDA- 2019/02/01 06:00
CRDT- 2017/12/25 06:00
PHST- 2017/08/15 00:00 [received]
PHST- 2017/11/26 00:00 [revised]
PHST- 2017/12/04 00:00 [accepted]
PHST- 2017/12/25 06:00 [pubmed]
PHST- 2019/02/01 06:00 [medline]
PHST- 2017/12/25 06:00 [entrez]
AID - heartjnl-2017-312310 [pii]
AID - 10.1136/heartjnl-2017-312310 [doi]
PST - ppublish
SO  - Heart. 2018 Jul;104(14):1208-1215. doi: 10.1136/heartjnl-2017-312310. Epub 2017
      Dec 23.