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The impact of advanced Interatrial block on new-onset atrial fibrillation following TAVR procedure

2016; Elsevier BV; Volume: 223; Linguagem: Inglês

10.1016/j.ijcard.2016.08.083

1874-1754

Bryce Alexander, Claudia Rodríguez, Leopoldo Pérez de Isla, Fabián Islas, Pilar Jiménez‐Quevedo, Luis Nombela‐Franco, Wilma M. Hopman, Paul Malik, Adrián Baranchuk,

Cardiac Arrhythmias and Treatments

Aortic stenosis (AS) is the most common valvular disease in the United States and Europe, affecting more than 9.8% of patients aged 80 to 89 years [ [1] Eveborn G.W. Schirmer H. Heggelund G. Lunde P. Rasmussen K. The evolving epidemiology of valvular aortic stenosis. The Tromsø study. Heart. 2013; 99: 396-400 Crossref PubMed Scopus (349) Google Scholar ]. Left untreated, severe AS carries a dismal prognosis [ [2] Sorgato A. Faggiano P. Ventricular arrhythmias in adult aortic stenosis. Chest. 1998; 113: 482-491 Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar ]. The transcatheter aortic valve replacement (TAVR) procedure was first performed in 2002 by Alain Cribier and has become a key procedure for those deemed too high risk for traditional aortic valve replacement (AVR) using a conventional sternotomy, cardioplegia and cardiopulmonary bypass. The recent PARTNER trial found TAVR to be non-inferior to traditional AVR in terms of all cause death. However, a concerning risk for stroke and vascular complications following TAVR as well as major bleeding and new-onset atrial fibrillation (AF) were described. No efforts to identify patients at higher risk of post-TAVR AF have been made so far [ [3] Smith C. Leon M. Mack M. et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N. Engl. J. Med. 2011; 364: 2187-2198 Crossref PubMed Scopus (4766) Google Scholar ].