Burden of New-Onset A-Fib Considerable After TAVI, AVR

The burden of new-onset atrial fibrillation is considerable following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR), and the odds of in-hospital mortality are increased with new-onset atrial fibrillation, according to a study published in JAMA Internal Medicine.

In a population-based observation study, Rajat Kalra, M.B.Ch.B., from the University of Minnesota in Minneapolis, and colleagues examined the incidence of new-onset atrial fibrillation and the incidence of in-hospital mortality associated with this atrial fibrillation after TAVI and AVR. Data were included for 48,715 TAVI hospitalizations and 122,765 AVR hospitalizations from the National Inpatient Sample.

The researchers found that new-onset atrial fibrillation occurred in 50.4 and 50.1 percent of TAVI and AVR hospitalizations, respectively. Compared with hospitalizations without new-onset atrial fibrillation, the odds of in-hospital mortality were increased in TAVI and AVR hospitalizations with new-onset atrial fibrillation in the multivariable-adjusted model (odds ratios, 1.57 and 1.36, respectively). These results were confirmed in the New York state inpatient database, with incidence rates of new-onset atrial fibrillation of 14.1 and 30.6 percent after TAVI and AVR, respectively.

"The use of TAVI and aortic valve replacement will only continue to increase as the American population ages," Kalra said in a statement. "However, we are now acknowledging that there can be many unintended effects from TAVI and surgical aortic valve replacement."

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