Study Assesses the Outcomes of Aortic Valve Replacement in AFib

Researchers of a study sought to assess the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) with  atrial fibrillation (AF). The results appeared online in Expert Review of Cardiovascular Therapy.

To conduct this analysis, researchers used the National Inpatient Sample database from 2011 to 2018. Baseline characteristics and in-hospital outcomes were evaluated in TAVR based on AF status or not in both unmatched and propensity-matched cohorts. In total, the study comprised 215,938 patients who underwent TAVR.

According to the results, the AF population TAVR had a higher mean age and had increased burden of key co-morbidities compared to their non-AF counterparts. The researchers observed with propensity matched 1:1 analysis, AF had higher mortality as compared to no-AF group (2.4% vs. 2.1%, p<0.01). They noted that the rate of cardiogenic shock (2.9% vs 2.1%), respiratory complications (9.9% vs 8.2%), acute kidney injury (15.6% vs 12.0%), vascular complications (5.0% vs 4.7%) and blood transfusion (10.4% vs 8.6%) was higher in TAVR patients with AF. Moreover, they further noted, there was a lower proportion of patients had routine discharge to home for TAVR with AF (80.8% vs 74.4%). Cost of hospitalization (23,0171[SD, 20,5242] vs 210608[28,4203]) and length of stay (5.7[SD, 11.8] vs 4.29[7.2] days) were considerably higher in patients undergoing TAVR with AF.

“Patients undergoing TAVR with concomitant AF tended to have increased mortality, complications, length, and cost of stay compared to non-AF patients,” the researchers concluded.