Low-risk patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) face a higher risk of poor outcomes if they have atrial fibrillation (AFib) or atrial flutter (AF), according to a new analysis published in the American Journal of Cardiology.
“In patients with aortic stenosis at high surgical risk or deemed inoperable undergoing TAVR as well as those undergoing SAVR, preexisting AFib/AF has been associated with an increased risk of mortality and rehospitalization,” wrote lead author Bahira Shahim, MD, PhD, of the Cardiovascular Research Foundation in New York City, and colleagues. “Nevertheless, whether AFib/AF is a prognostic factor in low-risk patients undergoing TAVR or SAVR for severe aortic stenosis remains unknown.”
The study’s authors explored data from more than 900 low-risk patients who participated in the PARTNER 3 trial. All patients had severe aortic stenosis and were randomized to either undergo TAVR or SAVR. More than 17% of the cohort had either AFib or AF going into the procedure, and patients were excluded altogether if their AFib/AF status could not be confirmed.
Overall, patients with AFib or AF had a higher adjusted rate (21.2% vs. 12.9%) of the study’s primary endpoint, a composite of all-cause mortality, stroke and rehospitalization after two years. Patients with AFib or AF also faced a higher risk of rehospitalization alone after two years—but not all-cause mortality alone or stroke alone.
Whether the patient underwent TAVR or SAVR did not appear to make a significant impact one way or the other. The risk of bleeding was also similar between the two patient groups.
Click here to read the full analysis in the American Journal of Cardiology.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.