Atrial fibrillation in transcatheter aortic valve implantation patients: Incidence, outcome and predictors of new onset

Background: There is controversial evidence if atrial fibrillation (AF) alters outcome after transcatheter aortic valve implantation (TAVI). TAVI itself may promote new-onset AF (NOAF). Methods: We performed a single-center study including 398 consecutive patients undergoing TAVI. Before TAVI, patients were divided into a sinus rhythm (SR) group (n = 226, 57%) and baseline AF group (is = 172, 43%) according to clinical records and electrocardiograms. Furthermore, incidence and predictors of NOAF were recorded. Results: Baseline AF patients had a significantly higher 1-year mortality than the baseline SR group (19.8% vs. 11.5%, p = 0.02). NOAF occurred in 7.1% of patients with prior SR. Previous valve surgery was the only significant predictor of NOAF (HR 5.86 [1.04-32.94], p < 0.05). NOAF was associated with higher rehospitalization rate (62.5 vs. 34.8%, p = 0.04), whereas mortality was unaffected. Conclusions: This study shows that NOAF is associated with higher rates of rehospitalization but not mortality after TAVI. Overall, patients with pre-existing AF have higher mortality. (C) 2017 Elsevier Inc. All rights reserved.