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Prognostic value of new onset atrial fibrillation after transcatheter aortic valve implantation: A FRANCE 2 registry substudy

  • Author Footnotes
    1 The two first authors equally contributed to this work.
    ,
    Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Akira Furuta
    Correspondence
    Corresponding author at: Cardiovascular Center, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, 362-8588, Saitama, Japan.
    Footnotes
    1 The two first authors equally contributed to this work.
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    1 The two first authors equally contributed to this work.
    ,
    Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Nicolas Lellouche
    Footnotes
    1 The two first authors equally contributed to this work.
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Gauthier Mouillet
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Tarvinder Dhanjal
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Martine Gilard
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Centre-Hospitalier-Universitaire de Brest, Hôpital de la Cavale-Blanche, Boulevard Tanguy Prigent, 29609 Brest, France
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  • Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Marc Laskar
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiac Surgery Unit, Centre-Hospitalier-Universitaire de Limoges, 2 Avenue Martin Luther king, 87042 Limoges, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Helene Eltchaninoff
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Centre-Hospitalier-Universitaire de Rouen, 1 rue de Germont, Rouen, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Jean Fajadet
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Clinique Pasteur, Centre de recherche cardiologique, 1 rue de la petite vitesse, 31000 Toulouse, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Bernard Iung
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Centre-Hospitalier-Universitaire Xavier Bichat, Université Paris Diderot, 16 rue Henri-Huchard, 75018 Paris, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Patrick Donzeau-Gouge
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiac Surgery Unit, Institut-Cardiovasculaire Paris-Sud, Massy, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Pascal Leprince
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiac Surgery Unit, Centre-Hospitalier-Universitaire Pitié salpêtrière, Université Paris, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Alain Leuguerrier
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    CHU Rennes, 2 rue Henri le Guilloux, Rennes, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Alain Prat
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiac Surgery Unit, Centre-Hospitalier-Universitaire de Lille, 12 rue Jean Jaurès, Lille, France
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    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Jean-Luc Dubois-Rande
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Emmanuel Teiger
    Footnotes
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
    Affiliations
    Cardiology Department, Hôpital Henri-Mondor, Assistance-Publique-Hôpitaux-de-Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France
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  • Author Footnotes
    1 The two first authors equally contributed to this work.
    2 The all authors are on behalf of FRANCE 2 Registry Investigators.
Published:February 13, 2016DOI:https://doi.org/10.1016/j.ijcard.2016.02.073

      Highlights

      • Patients were divided into 2 groups by the presence or absence of NOAF post-TAVI.
      • No-NOAF was observed in 92.4% (control group) and NOAF in 7.6% (NOAF group).
      • Thirty-day and 1-year mortalities were significantly higher in the NOAF group.
      • Age and major and life-threatening bleeding are the independent predictors of NOAF.
      • Trend towards a higher incidence of bleeding was only observed in the TA approach.

      Abstract

      Background

      The development of new onset atrial fibrillation (NOAF) post-transcatheter aortic valve implantation (TAVI) is common and may be associated with an adverse prognosis. This study seeks to identify incidence, predictors, and impact of NOAF post-TAVI.

      Methods

      From the multicenter study of the French national transcatheter aortic valve implantation registry, FRANCE 2, a total of 1959 patients with sinus rhythm prior to TAVI were enrolled into this study. The incidence of post-TAVI NOAF, predictors of development of NOAF and impact on 30-day and 1-year-mortalities were assessed.

      Results

      Of the 1959 TAVI patients (mean-age: 82.6 ± 7.5 years, mean-logistic-EuroSCORE: 21.8 ± 14.3), 149 (7.6%) developed NOAF with the remaining 1810 (92.4%) control patients demonstrating no evidence of AF as defined by the Valve Academic Research Consortium (VARC). Advanced age and major and life-threatening bleeding were independent predictors of NOAF (95% CI: 0.93–0.99; p = 0.006, 95% CI: 1.58–4.00; p < 0.001, 95% CI: 1.09–3.75; p = 0.025, respectively). A trend towards a higher incidence of major and life-threatening bleeding was observed in the patients undergoing TAVI via the transapical (TA)-approach compared with the transfemoral (TF)-approach. Both 30-day and cumulative 1-year-mortalities were significantly higher in patients with NOAF compared to patients without NOAF (3.0% vs. 7.4%; p = 0.005, 9.1% vs. 20.8%; p < 0.001, respectively). In addition, NOAF was an independent predictor of 30-day and 1-year-mortalities (HR: 2.16; 95% CI: 1.06–4.41; p = 0.033, HR: 2.12; 95% CI: 1.42–3.15; p < 0.001, respectively).

      Conclusion

      Advanced age and major and life-threatening bleeding were independently associated with increased incidence of NOAF, which itself was an independent predictor of 30-day and 1-year-mortalities. With regards to the various transcatheter approaches, a trend towards a higher incidence of major and life-threatening bleeding was observed only with the TA-approach.

      Key words

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