Arrhythmias & electrophysiology
New-onset atrial fibrillation detected by ambulatory ECG monitoring after transcatheter aortic valve implantation
Authors' conclusion
NOAF detected with AECG occurred in 7% of TAVI recipients and was associated with a higher AS severity. NOAF detection determined the start of anticoagulation therapy in about half of the patients, and it was not associated with an increased risk of clinical events at 1-year follow-up.
Study context
- Population
- Patients with aortic stenosis (AS) and no previous AF undergoing transarterial transcatheter aortic valve implantation (TAVI), with continuous ambulatory ECG monitoring after TAVI
- Participants
- 700 patients
- Exposure
- New-onset atrial fibrillation (NOAF) vs no NOAF after TAVI
- Outcome
- Incidence of subclinical NOAF
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
NOAF incidence
| Group | Value | Median duration | AF burden |
|---|---|---|---|
| NOAF | 7% | 185 (43-421) minutes | 0.7% [0.3-2.8] |
NOAF
Value7%
Median duration185 (43-421) minutes
AF burden0.7% [0.3-2.8]
Observational data: associations, not effects.
Further findings
| Outcome | Values | OR (95% CI) | P value | |
|---|---|---|---|---|
| Predictor of NOAF: baseline mean transaortic gradient (multivariable)Per mmHg | 1.04 (1.01–1.06) | P = 0.006 | ||
| 0.512Odds ratio (log scale) |
| Outcome | Values | P value |
|---|---|---|
| Anticoagulation started (NOAF patients) | NOAF 51% | |
| Baseline peak gradientNOAF vs no NOAF | no NOAF 71.9 (SD 23.5) mmHg · NOAF 85.2 (SD 23.8) mmHg | P = 0.024 |
| Baseline mean gradientNOAF vs no NOAF | no NOAF 44.4 (SD 14.7) mmHg · NOAF 53.8 (SD 16.8) mmHg | P = 0.004 |
| All-cause mortality · 30 days to 1 yearNOAF vs no NOAF | no NOAF 4.7% · NOAF 0% | P = 0.122 |
| Stroke · 30 days to 1 yearNOAF vs no NOAF | no NOAF 1.4% · NOAF 2.0% | P = 0.723 |
Safety
Bleeding · 30 days to 1 year
P = 0.288
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
New-onset atrial fibrillation detected by ambulatory ECG monitoring after transcatheter aortic valve implantation. EuroIntervention. Published 10 May 2024. doi:10.
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