Impact of Atrial Fibrillation on Outcomes in Very Severe Aortic Valve Stenosis
Section snippets
Methods
From January 1, 2008 to December 31, 2016, of 3,139 patients with aortic valve area (AVA) ≤1 cm2 or indexed to body surface area ≤0.6 cm2/m2 and left ventricular (LV) ejection fraction (LVEF) ≥50%, patients with native valve transaortic valve peak velocity ≥5 m/s were identified retrospectively from the echocardiographic laboratory database at Mayo Clinic, Rochester, Minnesota. Patients were grouped according to rhythm (SR vs AF) at time of index transthoracic echocardiography. Patients with
Results
A total of 563 patients with aortic jet velocity ≥5 m/s were identified; 50 of 563 patients (9%) had AF and 513 of 563 patients (91%) had SR during the index transthoracic echocardiogram. Baseline clinical characteristics are summarized in Table 1. Patients with AF were older (83.1 ± 7.5 vs 72.5 ± 12.2 years, p <0.001), without any difference in gender distribution (AF: men 50% vs SR: men 58%, p = 0.29). Patients with AF more frequently had a history of congestive heart failure (34 vs 13%, p
Discussion
The main findings of the present study are that (1) AF was not uncommon among patients with vsAS, (2) the overall survival was lower in patients with AF than patients in SR, and (3) AVR was associated with improved outcomes in both AF and SR groups but, overall, was performed less often in patients with AF.
Increased jet velocity across the aortic valve ≥5 versus <5 m/s in patients with AS has been linked to poor outcomes.2, 3, 4, 5, 6, 7 Lancellotti et al4 showed that in initially asymptomatic
Disclosures
The authors have no conflicts of interest to declare.
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Funding: none.