Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement

Background: Atrial fibrillation (AF) in severe aortic stenosis (AS) has poor outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively). We compared the incidence of AF after aortic valve replacement (AVR) according to the treatment method and the impact of AF o...

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Autores principales:	Hyung Ki Jeong, Namsik Yoon, Ju Han Kim, Nuri Lee, Dae Yong Hyun, Min Chul Kim, Ki Hong Lee, Yo Cheon Jeong, In Seok Jeong, Hyun Ju Yoon, Kye Hun Kim, Hyung Wook Park, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	atrial fibrillation incidence aortic stenosis transcatheter aortic valve replacement surgical aortic valve replacement outcome Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/1b3b9c979a6a45b3b544713b818ae9b5
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spelling	oai:doaj.org-article:1b3b9c979a6a45b3b544713b818ae9b52021-12-01T13:35:46ZPost-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement2297-055X10.3389/fcvm.2021.789548https://doaj.org/article/1b3b9c979a6a45b3b544713b818ae9b52021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.789548/fullhttps://doaj.org/toc/2297-055XBackground: Atrial fibrillation (AF) in severe aortic stenosis (AS) has poor outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively). We compared the incidence of AF after aortic valve replacement (AVR) according to the treatment method and the impact of AF on outcomes.Methods: We investigated the incidence of AF and clinical outcomes of AVR according to whether AF occurred after TAVR and SAVR after propensity score (PS)-matching for 1 year follow-up. Clinical outcomes were defined as death, stroke, and admission due to heart failure. The composite outcome comprised death, stroke, and admission due to heart failure.Results: A total of 221 patients with severe AS were enrolled consecutively, 100 of whom underwent TAVR and 121 underwent SAVR. The incidence of newly detected AF was significantly higher in the SAVR group before PS-matching (6.0 vs. 40.5%, P < 0.001) and after PS-matching (7.5 vs. 35.6%, P = 0.001). TAVR and SAVR showed no significant differences in outcomes except in terms of stroke. In the TAVR group, AF history did not affect the outcomes; however, in the SAVR group, AF history affected death (log rank P = 0.038). Post-AVR AF had a worse impact on admission due to heart failure (log rank P = 0.049) and composite outcomes in the SAVR group. Post-AVR AF had a worse impact on admission due to heart failure (log rank P = 0.008) and composite outcome in the TAVR group.Conclusion: Post-AVR AF could be considered as a predictor of the outcomes of AVR. TAVR might be a favorable treatment option for patients with severe symptomatic AS who are at high-risk for AF development or who have a history of AF because the occurrence of AF was more frequent in the SAVR group.Hyung Ki JeongHyung Ki JeongNamsik YoonJu Han KimNuri LeeDae Yong HyunMin Chul KimKi Hong LeeYo Cheon JeongIn Seok JeongHyun Ju YoonKye Hun KimHyung Wook ParkYoungkeun AhnMyung Ho JeongJeong Gwan ChoFrontiers Media S.A.articleatrial fibrillationincidenceaortic stenosistranscatheter aortic valve replacementsurgical aortic valve replacementoutcomeDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation incidence aortic stenosis transcatheter aortic valve replacement surgical aortic valve replacement outcome Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atrial fibrillation incidence aortic stenosis transcatheter aortic valve replacement surgical aortic valve replacement outcome Diseases of the circulatory (Cardiovascular) system RC666-701 Hyung Ki Jeong Hyung Ki Jeong Namsik Yoon Ju Han Kim Nuri Lee Dae Yong Hyun Min Chul Kim Ki Hong Lee Yo Cheon Jeong In Seok Jeong Hyun Ju Yoon Kye Hun Kim Hyung Wook Park Youngkeun Ahn Myung Ho Jeong Jeong Gwan Cho Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
description	Background: Atrial fibrillation (AF) in severe aortic stenosis (AS) has poor outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively). We compared the incidence of AF after aortic valve replacement (AVR) according to the treatment method and the impact of AF on outcomes.Methods: We investigated the incidence of AF and clinical outcomes of AVR according to whether AF occurred after TAVR and SAVR after propensity score (PS)-matching for 1 year follow-up. Clinical outcomes were defined as death, stroke, and admission due to heart failure. The composite outcome comprised death, stroke, and admission due to heart failure.Results: A total of 221 patients with severe AS were enrolled consecutively, 100 of whom underwent TAVR and 121 underwent SAVR. The incidence of newly detected AF was significantly higher in the SAVR group before PS-matching (6.0 vs. 40.5%, P < 0.001) and after PS-matching (7.5 vs. 35.6%, P = 0.001). TAVR and SAVR showed no significant differences in outcomes except in terms of stroke. In the TAVR group, AF history did not affect the outcomes; however, in the SAVR group, AF history affected death (log rank P = 0.038). Post-AVR AF had a worse impact on admission due to heart failure (log rank P = 0.049) and composite outcomes in the SAVR group. Post-AVR AF had a worse impact on admission due to heart failure (log rank P = 0.008) and composite outcome in the TAVR group.Conclusion: Post-AVR AF could be considered as a predictor of the outcomes of AVR. TAVR might be a favorable treatment option for patients with severe symptomatic AS who are at high-risk for AF development or who have a history of AF because the occurrence of AF was more frequent in the SAVR group.
format	article
author	Hyung Ki Jeong Hyung Ki Jeong Namsik Yoon Ju Han Kim Nuri Lee Dae Yong Hyun Min Chul Kim Ki Hong Lee Yo Cheon Jeong In Seok Jeong Hyun Ju Yoon Kye Hun Kim Hyung Wook Park Youngkeun Ahn Myung Ho Jeong Jeong Gwan Cho
author_facet	Hyung Ki Jeong Hyung Ki Jeong Namsik Yoon Ju Han Kim Nuri Lee Dae Yong Hyun Min Chul Kim Ki Hong Lee Yo Cheon Jeong In Seok Jeong Hyun Ju Yoon Kye Hun Kim Hyung Wook Park Youngkeun Ahn Myung Ho Jeong Jeong Gwan Cho
author_sort	Hyung Ki Jeong
title	Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
title_short	Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
title_full	Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
title_fullStr	Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
title_full_unstemmed	Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement
title_sort	post-operative atrial fibrillation impacts on outcomes in transcatheter and surgical aortic valve replacement
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1b3b9c979a6a45b3b544713b818ae9b5
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Post-operative Atrial Fibrillation Impacts on Outcomes in Transcatheter and Surgical Aortic Valve Replacement

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