Outcomes of transcatheter aortic valve replacement in patients with and without atrial fibrillation: Insight from national inpatient sample

Muhammad Zia Khan, Salman Zahid, Muhammad U. Khan, Asim Kichloo, Shakeel Jamal, Abdul Mannan Khan Minhas, Waqas Ullah, Yasar Sattar, Tanveer Mir, Sudarshan Balla, Muhammad Bilal Munir

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Atrial fibrillation (AF) is one of the most frequent rhythm disturbance encountered in the population in general. Our study aims to evaluate the in-hospital outcomes of TAVR with AF. Methods: We used National Inpatient Sample database from 2011 to 2018. Baseline characteristics and in-hospital outcomes were evaluated in TAVR based on AF status or not in both unmatched and propensity-matched cohorts. Results: A total of 215,938 patients underwent TAVR during our study period and out of these AF was encountered in 89,587 (41.5%) patients. AF patients undergoing TAVR had a higher mean age and had an increased burden of key co-morbidities in the unmatched cohort. With propensity matched 1:1 analysis, AF had higher mortality as compared to no-AF group (2.4% vs. 2.1%, p < 0.01). The rate of cardiogenic shock (2.9% vs 2.1%), respiratory complications (9.9% vs 8.2%), acute kidney injury (15.6% vs 12.0%), vascular complications (5.0% vs 4.7%), and blood transfusion (10.4% vs 8.6%) was higher in TAVR patients with AF. A lower proportion of patients had routine discharge to home for TAVR with AF (80.8% vs 74.4%). Cost of hospitalization (23,0171[SD, 20,5242] vs 210,608[28,4203]) and length of stay (5.7[SD, 11.8] vs 4.29[7.2] days) were considerably higher in patients undergoing TAVR with AF. Conclusion: Patients undergoing TAVR with concomitant AF tended to have increased mortality, complications, length, and cost of stay compared to non-AF patients.

Original languageEnglish
Pages (from-to)939-946
Number of pages8
JournalExpert Review of Cardiovascular Therapy
Volume19
Issue number10
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • AF
  • AS
  • NIS
  • TAVI
  • TAVR

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