Giuseppe Tarantini1, Marco Mojoli2, Stephan Windecker3, Olaf Wendler4, Thierry Lefèvre5, Francesco Saia6, Thomas Walther7, Paolo Rubino8, Antonio L Bartorelli9, Massimo Napodano2, Augusto D'Onofrio2, Gino Gerosa2, Sabino Iliceto2, Alec Vahanian10. 1. Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padova, Padua, Italy. Electronic address: giuseppe.tarantini.1@gmail.com. 2. Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padova, Padua, Italy. 3. Department of Cardiology, Bern University Hospital, Bern, Switzerland. 4. King's College Hospital, London, United Kingdom. 5. Cardiovascular Institute Paris-Sud, Massy, France. 6. University Hospital Policlinic S. Orsola-Malpighi, Institute of Cardiology, Bologna, Italy. 7. Kerckhoff Clinic, Bad Nauheim, Germany. 8. Cardiology Division, Clinica Montevergine, Mercogliano, Italy. 9. Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy. 10. Cardiology Department, Hospital Bichat-Claude Bernard, Paris, France.
Abstract
OBJECTIVES: The aims of this study were to assess the epidemiology of atrial fibrillation (AF) in patients treated with transcatheter aortic valve replacement (TAVR) and included in the large prospective SOURCE XT (SAPIEN XT Aortic Bioprosthesis Multi-Region Outcome Registry) study and to evaluate their outcomes according to the presence of pre-existing or new-onset AF (NOAF) (defined as AF occurring within 30 days after TAVR). BACKGROUND: Data on the epidemiology and clinical impact of AF in patients undergoing TAVR are scant and limited to small retrospective studies. METHODS: The SOURCE XT study is a multicenter, prospective registry of consecutive patients treated with the SAPIEN XT valve at 99 sites in 17 countries. Follow-up was scheduled at discharge, 1 month, 1 year, and yearly thereafter. Patients (n = 2,706) were categorized according to the presence of pre-existing or NOAF. RESULTS: The prevalence of pre-existing AF was 35.6%, whereas NOAF occurred in 7.2% of patients. Both pre-existing AF and NOAF correlated with worse clinical outcomes compared with patients in sinus rhythm, including all-cause death, cardiac death, and bleeding events. NOAF was associated with higher rates of stroke at 2 years compared with sinus rhythm. Independent predictors of NOAF were age (hazard ratio: 1.1), New York Heart Association class III or IV (hazard ratio: 1.9), nontransfemoral access route (hazard ratio: 3), and balloon post-dilation (odds ratio: 1.6). No interaction was observed between any degree of post-implantation paravalvular leak and NOAF. CONCLUSIONS: In the large dataset of the SOURCE XT registry, the presence of either pre-existing or NOAF increased all-cause and cardiac mortality and bleeding events. NOAF was associated with increased stroke rates at long-term follow-up.
OBJECTIVES: The aims of this study were to assess the epidemiology of atrial fibrillation (AF) in patients treated with transcatheter aortic valve replacement (TAVR) and included in the large prospective SOURCE XT (SAPIEN XT Aortic Bioprosthesis Multi-Region Outcome Registry) study and to evaluate their outcomes according to the presence of pre-existing or new-onset AF (NOAF) (defined as AF occurring within 30 days after TAVR). BACKGROUND: Data on the epidemiology and clinical impact of AF in patients undergoing TAVR are scant and limited to small retrospective studies. METHODS: The SOURCE XT study is a multicenter, prospective registry of consecutive patients treated with the SAPIEN XT valve at 99 sites in 17 countries. Follow-up was scheduled at discharge, 1 month, 1 year, and yearly thereafter. Patients (n = 2,706) were categorized according to the presence of pre-existing or NOAF. RESULTS: The prevalence of pre-existing AF was 35.6%, whereas NOAF occurred in 7.2% of patients. Both pre-existing AF and NOAF correlated with worse clinical outcomes compared with patients in sinus rhythm, including all-cause death, cardiac death, and bleeding events. NOAF was associated with higher rates of stroke at 2 years compared with sinus rhythm. Independent predictors of NOAF were age (hazard ratio: 1.1), New York Heart Association class III or IV (hazard ratio: 1.9), nontransfemoral access route (hazard ratio: 3), and balloon post-dilation (odds ratio: 1.6). No interaction was observed between any degree of post-implantation paravalvular leak and NOAF. CONCLUSIONS: In the large dataset of the SOURCE XT registry, the presence of either pre-existing or NOAF increased all-cause and cardiac mortality and bleeding events. NOAF was associated with increased stroke rates at long-term follow-up.
Authors: Sarah K L Moore; Katherine H Chau; Salma Chaudhary; Geoffrey Rubin; Joseph Bayne; Uma Mahesh R Avula; Daniel Y Wang; Carmine Sorbera; Jose Dizon; Angelo Biviano; Marc Waase; Vivek Iyer; Isaac George; Susheel K Kodali; Tamim M Nazif; Hasan Garan; Elaine Y Wan Journal: Pacing Clin Electrophysiol Date: 2019-03-18 Impact factor: 1.976
Authors: Matthew W Sherwood; Aakriti Gupta; Sreekanth Vemulapalli; Zhuokai Li; Jonathan Piccini; J Kevin Harrison; David Dai; Amit N Vora; Michael J Mack; David R Holmes; John S Rumsfeld; David J Cohen; Vinod H Thourani; Ajay J Kirtane; Eric D Peterson Journal: Circ Cardiovasc Interv Date: 2021-04-20 Impact factor: 6.546
Authors: Line Melgaard; Thure Filskov Overvad; Martin Jensen; Thomas Decker Christensen; Gregory Y H Lip; Torben Bjerregaard Larsen; Peter Brønnum Nielsen Journal: J Am Heart Assoc Date: 2021-11-24 Impact factor: 6.106