Abstract 17377: Incidence of Atrial Fibrillation After Aortic Valve Replacement With a Bioprosthesis
Introduction: Atrial fibrillation (AF) is a frequent comorbidity in patients undergoing aortic valve replacement with a bioprosthesis.
Hypothesis: The incidence of AF in the long-term follow-up post-operatively remains unknown.
Methods: FIN-bioAVR study sought to assess the rate and timing of AF in patients who underwent isolated aortic valve replacement with a bioprosthesis. Between 2002 and 2014, 784 patients underwent isolated aortic valve replacement with bioprosthesis in 4 University Hospitals in Finland. Patient records were individually assessed to detect AF in a median [IQR] of 4.7 [2.9-6.9] years follow-up.
Results: At the time of index surgery, median age of patients was 76 [71-79] years, CHA2DS2-VASc score 4 [3-5], and 435/784 (55.5%) were females. Altogether 99/784 (12.6%) of patients were in chronic AF and additionally 106/784 (13.5%) had a history of paroxysmal AF prior to index operation. During postoperative hospitalization when patients with prior chronic AF were excluded, a total of 368/685 (53.7%) of patients had at least one new-onset paroxysm of AF and a diagnosis of chronic AF was placed in 73/685 (10.7%) of them. After hospitalization, AF was detected in 221/612 (36.1%) of patients who were not in chronic AF prior to index surgery or during hospitalization. Cumulative incidence of at least one episode of AF at the end of follow-up was 543/784 (69.2%). Incidence of AF after hospitalization was higher in patients with vs. without new-onset in-hospital AF (42.4% vs. 15.8%, p<0.001; OR 3.9 95%-CI 2.8-5.5, p<0.001).
Conclusions: In this large real-world population of patients undergoing aortic valve replacement with a bioprosthesis, AF was a frequent comorbidity affecting up to 70% of patients in long-term follow-up. This finding underscores the need for adequate protection against AF-related thromboembolic events in a frail patient population undergoing aortic valve replacement.
Author Disclosures: T. Kiviniemi: None. M. Malmberg: None. F. Biancari: None. J. Hartikainen: None. L. Ihlberg: None. F. Yannopoulos: None. T. Riekkinen: None. J. Airaksinen: None. T. Nieminen: None.
- © 2016 by American Heart Association, Inc.