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 ) .
Acute and 30-Day Outcomes in Women After TAVR: Results From the WIN-TAVI (Women's INternational Transcatheter Aortic Valve Implantation) Real-World Registry.
OBJECTIVES The study sought to examine the safety and performance of transcatheter aortic valve replacement ( TAVR ) using an all-female registry and to further explore the potential impact of female sex-specific characteristics on clinical outcomes after TAVR . BACKGROUND Although women comprise 50 % of patients with symptomatic severe aortic stenosis undergoing TAVR  , the optimal treatment strategy remains undetermined . METHODS The WIN-TAVI ( Women 's INternational Transcatheter Aortic Valve Implantation ) registry is a multinational , prospect i ve , observational registry of women undergoing TAVR for aortic stenosis , conducted without any external funding . The primary endpoint was the Valve Academic Research Consortium (VARC)-2 early safety endpoint at 30 days ( composite of mortality , stroke , major vascular complication , life-threatening bleeding , stage 2 or 3 acute kidney injury , coronary artery obstruction , or repeat procedure for valve-related dysfunction ) . RESULTS Between January 2013 and December 2015 , 1,019 women were enrolled across 19 European and North American centers . The mean patient age was 82.5 ± 6.3 years , mean EuroSCORE I was 17.8 ± 11.7 % and mean Society of Thoracic Surgeons score was 8.3 ± 7.4 % .  TAVR was performed via transfemoral access in 90.6 % and new-generation devices were used in 42.1 % . In more than two-thirds of cases , an Edwards SAPIEN 23 mm ( Edwards Lifesciences , Irvine , California ) or Medtronic CoreValve ≤26 mm ( Medtronic Inc. , Minneapolis , Minnesota ) device was implanted . The 30-day VARC-2 composite endpoint occurred in 14.0 % with 3.4 % all-cause mortality , 1.3 % stroke , 7.7 % major vascular complications , and 4.4 % VARC life-threatening bleeding . The independent predictors of the primary endpoint were age ( odds ratio [ OR ] : 1.04 ; 95 % confidence interval [ CI ] : 1.00 to 1.08 ) , prior stroke ( OR : 2.02 ; 95 % CI : 1.07 to 3.80 ) , left ventricular ejection fraction < 30 % ( OR : 2.62 ; 95 % CI : 1.07 to 6.40 ) , new device generation ( OR : 0.59 ; 95 % CI : 0.38 to 0.91 ) , and history of pregnancy ( OR : 0.57 ; 95 % CI : 0.37 to 0.85 ) . CONCLUSIONS Women enrolled in this first ever all-female TAVR registry with collection of female sex-specific baseline parameters , were at intermediate-high risk and experienced a 30-day VARC-2 composite safety endpoint of 14.0 % with a low incidence of early mortality and stroke . R and omized assessment of TAVR versus surgical aortic valve replacement in intermediate risk women is warranted to determine the optimal 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 ) .