New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches

Objectives: This study sought to determine the incidence of new-onset atrial fibrillation (AF) associated with different methods of isolated aortic valve replacement (AVR) - transfemoral (TF), transapical (TA), and transaortic (TAo) catheter-based valve replacement and conventional surgical approach...

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Main Authors: Tanyanan Tanawuttiwat, Brian P. O'Neill, Mauricio G. Cohen, Orawee Chinthakanan, Alan W. Heldman, Claudia A. Martinez, Carlos E. Alfonso, Raul D. Mitrani, Conrad J. Macon, Roger G. Carrillo, Donald B. Williams, William W. O'Neill, Robert J. Myerburg
Format: Journal
Published: 2018
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84902096270&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/45067
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-450672018-01-24T06:04:51Z New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches Tanyanan Tanawuttiwat Brian P. O'Neill Mauricio G. Cohen Orawee Chinthakanan Alan W. Heldman Claudia A. Martinez Carlos E. Alfonso Raul D. Mitrani Conrad J. Macon Roger G. Carrillo Donald B. Williams William W. O'Neill Robert J. Myerburg Objectives: This study sought to determine the incidence of new-onset atrial fibrillation (AF) associated with different methods of isolated aortic valve replacement (AVR) - transfemoral (TF), transapical (TA), and transaortic (TAo) catheter-based valve replacement and conventional surgical approaches. Background: The relative incidences of AF associated with the various access routes for AVR have not been well characterized. Methods: In this single-center, retrospective cohort study, we evaluated a total of 231 consecutive patients who underwent AVR for degenerative aortic stenosis (AS) between March 2010 and September 2012. Patients with a history of paroxysmal, persistent, or chronic AF, with bicuspid aortic valves, and patients who died within 48 h after AVR were excluded. A total of 123 patients (53% of total group) qualified for inclusion. Data on documented episodes of new-onset AF, along with all clinical, echocardiographic, procedural, and 30-day follow-up data, were collated. Results: AF occurred in 52 patients (42.3%). AF incidence varied according to the procedural method. AF occurred in 60% of patients who underwent surgical AVR (SAVR), in 53% after TA-TAVR, in 33% after TAo-TAVR cases, and 14% after TF-TAVR. The episodes occurred at a median time interval of 53 (25th to 75th percentile, 41 to 87) h after completion of the procedure. Procedures without pericardiotomy had an 82% risk reduction of AF compared with those with pericardiotomy (adjusted odds ratio: 0.18; 95% confidence interval: 0.05 to 0.59). Conclusions: AF was a common complication of AVR with a cumulative incidence of > 40% in elderly patients with degenerative AS who underwent either SAVR or TAVR. AF was most common with SAVR and least common with TF-TAVR. Procedures without pericardiotomy were associated with a lower incidence of AF. © 2014 by the American College of Cardiology Foundation. 2018-01-24T06:04:51Z 2018-01-24T06:04:51Z 2014-04-22 Journal 15583597 07351097 2-s2.0-84902096270 10.1016/j.jacc.2013.11.046 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84902096270&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/45067
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description Objectives: This study sought to determine the incidence of new-onset atrial fibrillation (AF) associated with different methods of isolated aortic valve replacement (AVR) - transfemoral (TF), transapical (TA), and transaortic (TAo) catheter-based valve replacement and conventional surgical approaches. Background: The relative incidences of AF associated with the various access routes for AVR have not been well characterized. Methods: In this single-center, retrospective cohort study, we evaluated a total of 231 consecutive patients who underwent AVR for degenerative aortic stenosis (AS) between March 2010 and September 2012. Patients with a history of paroxysmal, persistent, or chronic AF, with bicuspid aortic valves, and patients who died within 48 h after AVR were excluded. A total of 123 patients (53% of total group) qualified for inclusion. Data on documented episodes of new-onset AF, along with all clinical, echocardiographic, procedural, and 30-day follow-up data, were collated. Results: AF occurred in 52 patients (42.3%). AF incidence varied according to the procedural method. AF occurred in 60% of patients who underwent surgical AVR (SAVR), in 53% after TA-TAVR, in 33% after TAo-TAVR cases, and 14% after TF-TAVR. The episodes occurred at a median time interval of 53 (25th to 75th percentile, 41 to 87) h after completion of the procedure. Procedures without pericardiotomy had an 82% risk reduction of AF compared with those with pericardiotomy (adjusted odds ratio: 0.18; 95% confidence interval: 0.05 to 0.59). Conclusions: AF was a common complication of AVR with a cumulative incidence of > 40% in elderly patients with degenerative AS who underwent either SAVR or TAVR. AF was most common with SAVR and least common with TF-TAVR. Procedures without pericardiotomy were associated with a lower incidence of AF. © 2014 by the American College of Cardiology Foundation.
format Journal
author Tanyanan Tanawuttiwat
Brian P. O'Neill
Mauricio G. Cohen
Orawee Chinthakanan
Alan W. Heldman
Claudia A. Martinez
Carlos E. Alfonso
Raul D. Mitrani
Conrad J. Macon
Roger G. Carrillo
Donald B. Williams
William W. O'Neill
Robert J. Myerburg
spellingShingle Tanyanan Tanawuttiwat
Brian P. O'Neill
Mauricio G. Cohen
Orawee Chinthakanan
Alan W. Heldman
Claudia A. Martinez
Carlos E. Alfonso
Raul D. Mitrani
Conrad J. Macon
Roger G. Carrillo
Donald B. Williams
William W. O'Neill
Robert J. Myerburg
New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
author_facet Tanyanan Tanawuttiwat
Brian P. O'Neill
Mauricio G. Cohen
Orawee Chinthakanan
Alan W. Heldman
Claudia A. Martinez
Carlos E. Alfonso
Raul D. Mitrani
Conrad J. Macon
Roger G. Carrillo
Donald B. Williams
William W. O'Neill
Robert J. Myerburg
author_sort Tanyanan Tanawuttiwat
title New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
title_short New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
title_full New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
title_fullStr New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
title_full_unstemmed New-onset atrial fibrillation after aortic valve replacement: Comparison of transfemoral, transapical, transaortic, and surgical approaches
title_sort new-onset atrial fibrillation after aortic valve replacement: comparison of transfemoral, transapical, transaortic, and surgical approaches
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84902096270&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/45067
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