Impact of Atrial Fibrillation on Outcomes of Aortic Valve Implantation

Am J Cardiol. 2022 Jan 15:163:50-57. doi: 10.1016/j.amjcard.2021.09.036. Epub 2021 Nov 10.

Abstract

New or preexisting atrial fibrillation (AF) is frequent in patients undergoing aortic valve replacement. We evaluated whether the presence of AF during transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) impacts the length of stay, healthcare adjusted costs, and inpatient mortality. The median length of stay in the patients with AF increased by 33.3% as compared with those without AF undergoing TAVI and SAVR (5 [3 to 8] days vs 3 [2 to 6] days, p <0.0001 and 8 [6 to 12] days vs 6 [5 to 10] days, p <0.0001, respectively). AF increased the median value of adjusted healthcare associated costs of both TAVI ($46,754 [36,613 to 59,442] vs $49,960 [38,932 to 64,201], p <0.0001) and SAVR ($40,948 [31,762 to 55,854] vs $45,683 [35,154 to 63,026], p <0.0001). The presence of AF did not independently increase the in-hospital mortality. In conclusion, in patients undergoing SAVR or TAVI, AF significantly increased the length of stay and adjusted healthcare adjusted costs but did not independently increase the in-hospital mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / epidemiology
  • Aortic Valve Stenosis / surgery*
  • Atrial Fibrillation / epidemiology*
  • Comorbidity
  • Female
  • Health Care Costs / statistics & numerical data*
  • Heart Valve Prosthesis Implantation
  • Hospital Mortality*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome