University of Oulu

Jaakkola J, Jaakkola S, Airaksinen KEJ, Husso A, Juvonen T, Laine M, et al. (2020) Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study. PLoS ONE 15(9): e0238953. https://doi.org/10.1371/journal.pone.0238953

Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement : the FinnValve study

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Author: Jaakkola, Jussi1; Jaakkola, Samuli1; Airaksinen, K. E. Juhani1;
Organizations: 1Heart Center, Turku University Hospital and University of Turku, Turku, Finland
2Heart Center, Kuopio University Hospital, Kuopio, Finland
3Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
4Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, Oulu, Finland
5Heart Hospital, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
6Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020101584128
Language: English
Published: Public Library of Science, 2020
Publish Date: 2020-10-15
Description:

Abstract

Whether the subtype of atrial fibrillation affects outcomes after transcatheter aortic valve replacement for aortic stenosis is unclear. The nationwide FinnValve registry included 2130 patients who underwent primary after transcatheter aortic valve replacement for aortic stenosis during 2008–2017. Altogether, 281 (13.2%) patients had pre-existing paroxysmal atrial fibrillation, 651 (30.6%) had pre-existing non-paroxysmal atrial fibrillation and 160 (7.5%) were diagnosed with new-onset atrial fibrillation during the index hospitalization. The median follow-up was 2.4 (interquartile range: 1.6–3.8) years. Paroxysmal atrial fibrillation did not affect 30-day or overall mortality (p-values >0.05). Non-paroxysmal atrial fibrillation demonstrated an increased risk of overall mortality (hazard ratio: 1.61, 95% confidence interval: 1.35–1.92; p<0.001), but not 30-day mortality (p = 0.084). New-onset atrial fibrillation demonstrated significantly increased 30-day mortality (hazard ratio: 2.76, 95% confidence interval: 1.25–6.09; p = 0.010) and overall mortality (hazard ratio: 1.68, 95% confidence interval: 1.29–2.19; p<0.001). The incidence of early or late stroke did not differ between atrial fibrillation subtypes (p-values >0.05). In conclusion, non-paroxysmal atrial fibrillation and new-onset atrial fibrillation are associated with increased mortality after transcatheter aortic valve replacement for aortic stenosis, whereas paroxysmal atrial fibrillation has no effect on mortality. These findings suggest that non-paroxysmal atrial fibrillation rather than paroxysmal atrial fibrillation may be associated with structural cardiac damage which is of prognostic significance in patients with aortic stenosis undergoing transcatheter aortic valve replacement.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 15
Issue: 9
Article number: e0238953
DOI: 10.1371/journal.pone.0238953
OADOI: https://oadoi.org/10.1371/journal.pone.0238953
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: The authors received no specific funding for this work.
Copyright information: © 2020 Jaakkola et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  https://creativecommons.org/licenses/by/4.0/