Conclusions Systematic identification of new-onset arrhythmias following TAVI may have considerable impact on subsequent therapeutic management and long-term prognosis in this patient population
Objective To evaluate the prevalence and clinical impact of new-onset arrhythmias in patients following transcatheter aortic valve implantation ( TAVI ) .
Two-Year Outcomes in Patients With Severe Aortic Valve Stenosis Randomized to Transcatheter Versus Surgical Aortic Valve Replacement: The All-Comers Nordic Aortic Valve Intervention Randomized Clinical Trial
Background —The Nordic Aortic Valve Intervention ( NOTION ) trial was the first to r and omize all-comers with severe native aortic valve stenosis to either transcatheter aortic valve replacement ( TAVR ) with the CoreValve self-exp and ing bioprosthesis or surgical aortic valve replacement ( SAVR )  , including a lower-risk patient population than previous trials . This article reports 2-year clinical and echocardiographic outcomes from the NOTION trial . Methods and Results —Two-hundred eighty patients from 3 centers in Denmark and Sweden were r and omized to either TAVR  ( n=145 ) or SAVR  ( n=135 ) with follow-up planned for 5 years . There was no difference in all-cause mortality at 2 years between TAVR and SAVR ( 8.0 % versus 9.8 % , respectively ; P=0.54 ) or cardiovascular mortality ( 6.5 % versus 9.1 % ; P=0.40 ) . The composite outcome of all-cause mortality , stroke , or myocardial infa rct ion was also similar ( 15.8 % versus 18.8 % , P=0.43 ) . Forward-flow hemodynamics were improved following both procedures , with effective orifice area significantly more improved after TAVR than SAVR ( effective orifice area , 1.7 versus 1.4 cm2 at 3 months ) . Mean valve gradients were similar after TAVR and SAVR . When patients were categorized according to Society of Thoracic Surgeons Predicted Risk of Mortality ( STS-PROM ) ( < 4 % versus ≥4 % ) , there was no statistically significant difference for TAVR and SAVR groups in the composite outcome for low-risk ( 14.7 % , 95 % confidence interval , 8.3–21.2 versus 16.8 % ; 95 % confidence interval , 9.7–23.8 ; P=0.58 ) or intermediate-risk patients ( 21.1 % versus 27.1 % ; P=0.59 ) . Conclusions —Two-year results from the NOTION trial demonstrate the continuing safety and effectiveness of TAVR in lower-risk patients . Longer-term data are needed to verify the durability of this procedure in this patient population . Clinical Trial Registration —URL : http://www . clinical trials.gov . Unique identifier : NCT01057173
Conclusions Systematic identification of new-onset arrhythmias following TAVI may have considerable impact on subsequent therapeutic management and long-term prognosis in this patient population
Objective To evaluate the prevalence and clinical impact of new-onset arrhythmias in patients following transcatheter aortic valve implantation ( TAVI ) .