Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study
Marko Virtanen; Antti Vento; Tuomas Tauriainen; Tatu Juvonen; Pasi Maaranen; Mika Laine; Fausto Biancari; Markku Eskola; Peter Raivio; Antti Valtola; Annastiina Husso; K. E. Juhani Airaksinen; Mikko Savontaus; Timo Mäkikallio; Samuli Jaakkola; Matti Niemelä; Jussi Jaakkola
Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study
Marko Virtanen
Antti Vento
Tuomas Tauriainen
Tatu Juvonen
Pasi Maaranen
Mika Laine
Fausto Biancari
Markku Eskola
Peter Raivio
Antti Valtola
Annastiina Husso
K. E. Juhani Airaksinen
Mikko Savontaus
Timo Mäkikallio
Samuli Jaakkola
Matti Niemelä
Jussi Jaakkola
PUBLIC LIBRARY SCIENCE
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042821658
https://urn.fi/URN:NBN:fi-fe2021042821658
Tiivistelmä
Whether the subtype of atrial fibrillation affects outcomes after transcatheter aortic valve replacement for aortic stenosis is unclear. The nationwide FinnValve registry included 2130 patients who underwent primary after transcatheter aortic valve replacement for aortic stenosis during 2008-2017. Altogether, 281 (13.2%) patients had pre-existing paroxysmal atrial fibrillation, 651 (30.6%) had pre-existing non-paroxysmal atrial fibrillation and 160 (7.5%) were diagnosed with new-onset atrial fibrillation during the index hospitalization. The median follow-up was 2.4 (interquartile range: 1.6-3.8) years. Paroxysmal atrial fibrillation did not affect 30-day or overall mortality (p-values >0.05). Non-paroxysmal atrial fibrillation demonstrated an increased risk of overall mortality (hazard ratio: 1.61, 95% confidence interval: 1.35-1.92; p<0.001), but not 30-day mortality (p = 0.084). New-onset atrial fibrillation demonstrated significantly increased 30-day mortality (hazard ratio: 2.76, 95% confidence interval: 1.25-6.09; p = 0.010) and overall mortality (hazard ratio: 1.68, 95% confidence interval: 1.29-2.19; p<0.001). The incidence of early or late stroke did not differ between atrial fibrillation subtypes (p-values >0.05). In conclusion, non-paroxysmal atrial fibrillation and new-onset atrial fibrillation are associated with increased mortality after transcatheter aortic valve replacement for aortic stenosis, whereas paroxysmal atrial fibrillation has no effect on mortality. These findings suggest that non-paroxysmal atrial fibrillation rather than paroxysmal atrial fibrillation may be associated with structural cardiac damage which is of prognostic significance in patients with aortic stenosis undergoing transcatheter aortic valve replacement.
Kokoelmat
- Rinnakkaistallenteet [19207]