Patients with a history of atrial fibrillation (AFib) are more likely to experience adverse outcomes within two years of transcatheter aortic valve replacement (TAVR), according to new research published in the American Journal of Cardiology.[1]
The study’s authors explored data from more than 900 patients with severe aortic stenosis who underwent TAVR from 2012 to 2020. Approximately 35% of TAVR patients presented with a history of AFib. These AFib patients had a higher average age (80.1 vs. 77.6 years old) and higher mean Society of Thoracic Surgeons (STS) score (6.4% vs. 4.9%) than patients without AFib.
After a mean follow-up period of 2.4 years, overall morality was 22.7% among AFib patients and 14.4% among patients without AFib. AFib patients with CHA2DS2-VASc scores of 4 or higher faced a significantly higher risk of mortality than patients without AFib, but this was not true for AFib patients with a CHA2DS2-VASc score of 1 to 3.
The team also emphasized that AFib patients were much more likely to have heart failure-related hospitalizations (23.3% vs. 10%) or bleeding-related hospitalizations (15.5% vs. 5.7%) than patients without AFib. These secondary outcomes only became more common as a patient’s CHA2DS2-VASc score increased.
On the other hand, the 30-day permanent pacemaker, stroke and myocardial infarction hospitalizations rates were all similar among TAVR patients with and without AFib.
“This study helps to better understand intermediate-term outcomes in patients with AFib stratified by CHA2DS2-VASc scores who underwent TAVR and identify those patients at the highest risk for mortality to mitigate adverse events,” wrote first author Craig C. Morris, MD, of Oregon Health and Science University in Portland, and colleagues. “As the burden of AFib in this population remains high, understanding how TAVR affects AFib patients who require long-term anticoagulation for thromboembolic protection and prevention is an area of continued interest.”
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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.