Abstract 15931: Risk of Post Procedural Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valvular Replacement - A Meta-Analysis
Introduction: Atrial fibrillation is a common postoperative complication of surgical aortic valve replacement (SAVR). However, it is not known if the incidence of post procedure AF is impacted by performing Transcatheter Aortic Valvular Replacement (TAVR) instead of SAVR.
Hypothesis: There is no difference in risk of post procedure incident AF in patients undergoing TAVR vs. SAVR.
Methods: We systematically reviewed studies evaluating TAVR vs. SAVR and risk of post procedure AF. We searched MEDLINE, EMBASE, CINAHL, Web of Science, meeting abstracts, presentations and Cochrane central databases from inception through May 2015. For a study to be selected, it had to report the rates of incident AF in individuals undergoing TAVR. Data were extracted by 2 independent authors (WTQ and UBN). Forrest plot was created to show the effect sizes (Figure 1).
Results: A total of 8 studies including 2483 patients (mean age 81.4 years, 70.3% male) were analyzed. There were 1293 patients that underwent TAVR and 1190 patients that underwent SAVR. The 1- year incidence of AF was 231 (17.9%) in TAVR group vs. 377 (31.6%) in SAVR group. In a random effects model, patients treated with TAVR had a 48% decreased risk of post procedural 1 year risk of AF [pooled Risk Ratio (95% confidence interval) 0.52 (0.37-0.73), p <0.001]. There was moderate heterogeneity in the results (I2 = 80%). The risk of AF was higher in studies with older patients and was lower in studies with higher proportion of patients that underwent transfemoral TAVR vs. transapical TAVR.
Conclusions: In this meta-analysis, the post procedure risk of AF was lower in TAVR group as compared to SAVR group. The risk of post procedure AF should be considered while making decision for TAVR vs. SAVR.
Author Disclosures: W. Qureshi: None. U.B. Nasir: None. E.Z. Soliman: None. P.M. Belford: None. S.K. Gandhi: None. R.J. Applegate: None. D.X. Zhao: None.
- © 2015 by American Heart Association, Inc.