More than 3% of all patients who undergo transcatheter edge-to-edge repair (TEER) go on to develop new-onset atrial fibrillation (AFib), according to new research published in the American Journal of Cardiology.[1] The study’s authors noted that new-onset AFib has been linked to a higher risk of morbidity and mortality.
“It is important to understand better the role new-onset AFib has in the current era of TEER,” wrote first author Fabio V. Lima, MD, of the Warren Alpert Medical School of Brown University in Providence, Rhode Island, and colleagues. “Using the Nationwide Readmissions Database (NRD), we sought to characterize the nationwide incidence, timing, and predictors of new-onset AFib after TEER.”
Lima et al. tracked NRD data from 2016 to 2018, focusing on more than 4,000 adult patients who underwent TEER, previously known primarily as transcatheter mitral valve repair, for mitral regurgitation. After making exclusions, the team’s final cohort was made up of 3,972 patients.
Overall, 3.5% of TEER patients were rehospitalized within six months due to new-onset AFib. Patients who developed new-onset AFib tended to be sicker than patients who did not develop AFib—they also had a much higher 30-day readmission rate. The patients who developed new-onset AFib were also more likely to present with heart failure or have a history of coronary artery bypass grafting, stroke, transient ischemic attack, chronic kidney disease, fluid and electrolyte disorders or deficiency anemias.
“Knowledge of these predictors may help screen patients earlier in their clinical course for increased risk for new-onset AFib and rehospitalization,” the authors wrote.
The team also observed that the median healthcare costs were the higher among ($41,656) among patients with new-onset AFib than those who already had AFib ($41,236) or never developed AFib ($39,741).
There were certain limitations to this analysis. For example, the NRD does not include echocardiograph results and medication information, limiting the insights the authors could gain. Also, the group noted, they did not “definitively know whether those in the new-onset AFib group ever had AFib before their TEER.”
“A possible means to overcome this issue in future studies may be with pre-TEER rhythm monitoring,” the authors wrote.
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.