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 ) .
Temporal changes of new-onset atrial fibrillation in patients randomized to surgical or transcatheter aortic valve replacement.
BACKGROUND Temporal development of new-onset atrial fibrillation ( NOAF ) after aortic valve replacement is unclear , and opportunistic screening has limited diagnostic accuracy . This is the first study to investigate the incidence and temporal development of NOAF detected by implantable loop recorder ( ILR ) in patients with aortic stenosis , r and omized to surgical aortic valve replacement ( SAVR ) or transcatheter aortic valve replacement ( TAVR ) . METHOD An ILR was implanted in a subgroup of patients without pre-procedural atrial fibrillation ( AF ) , r and omized to SAVR or TAVR in the NOTION trial . Data from the ILR were transmitted in intervals of 2weeks for 12weeks post-procedurally and analyzed . RESULTS The study included 25 and 27 patients who underwent SAVR and TAVR , respectively . The cumulative rate of NOAF was 100 % and 81.5 % for patients undergoing SAVR and TAVR , respectively ( P=0.06 ) . TAVR patients without NOAF 6weeks post-procedurally remained free from NOAF . The prevalence of AF after SAVR decreased significantly after 8weeks when compared with the first 2weeks ( 50.0 % vs. 84.0 % , respectively ; P<0.05 ) . The prevalence of AF after TAVR did not change significantly during follow-up . The median AF burden ( percentage of time with AF ) was 2.8 % and 0.04 % during the first 2weeks after SAVR and TAVR , respectively ( P=0.01 ) and it decreased significantly over time after SAVR but not after TAVR . CONCLUSION NOAF subsided 6weeks after TAVR . AF prevalence and burden decreased significantly over time after SAVR , but remained stable after TAVR . These findings may be considered for post-procedural anti-coagulation strategy
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 ) .