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 ) .
Analysis of long-term survival following transcatheter aortic valve implantation from a single high-volume center.
Mortality after transcatheter aortic valve implantation ( TAVI )  has been reported to range up to 3 years . However , long-term mortality remains underexplored . The aims of this study were to determine long-term mortality in patients who undergo TAVI  and to identify correlates of long-term death . From a single institution 's prospect ively collected TAVI data base , all patients who underwent TAVI with a maximum follow-up duration of 5 years were analyzed . The population was analyzed on the basis of access route ( transapical TAVI or transfemoral TAVI ) . Cox regression and Kaplan-Meier survival analysis were conducted . A total of 511 patients who underwent TAVI were included in the analysis ( transapical TAVI n = 115 , transfemoral TAVI n = 396 ) . The mean Society of Thoracic Surgeons score was 9.6 ± 4 . Mortality at 30 days ( 18 % vs 6 % , p < 0.001 ) and 1 year ( 32 % vs 21 % , p < 0.01 ) was significantly increased in the transapical TAVI group . Long-term survival probability was < 50 % for the 2 approaches ( log-rank p = 0.33 ) . Vascular complications ( hazard ratio [ HR ] 2.14 , 95 % confidence interval [ CI ] 1.38 to 3.33 , p = 0.001 ) , more than mild aortic insufficiency ( HR 1.81 , 95 % CI 1.15 to 2.83 , p = 0.01 ) , atrial fibrillation ( HR 1.87 , 95 % CI 1.36 to 2.57 , p < 0.001 ) , and in-hospital stroke ( HR 2.35 , 95 % CI 1.39 to 4.00 , p = 0.002 ) were independently associated with long-term death . The survival probability of patients at high surgical risk versus those who were inoperable was similar in the long term ( log-rank p = 0.53 ) . In conclusion , the overall long-term survival of patients with aortic stenosis who were approved to undergo TAVI  was < 50 % irrespective of access method . Strategies geared toward reducing in-hospital stroke , vascular complications , and aortic regurgitation are still needed , as these variables are correlates of long-term mortality
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 ) .