Incidence, pathophysiology, predictive factors and prognostic implications of new onset at

Incidence, pathophysiology, predictive factors and prognostic implications of new onset atrial fibrillation following transcatheter aortic valve implantation

Ioanna Koniari1,*, Grigorios Tsigkas1, Nikolaos Kounis1, Dimitrios Velissaris2, Emmanouil Chourdakis3,Periklis Davlouros1, George Hahalis1

【期刊名称】老年心脏病学杂志（英文版）

【年(卷),期】2018(015)001

【总页数】5

【关键词】Keywords: Atrial fibrillation; Mortality; Prognosis; Transcatheter aoric valve implantation

1 Introduction

Atrial fibrillation (AF) constitutes the most frequent cardiac arrhythmia with an increasing prevalence and incidence in the general population, demonstrating a significant impact on cardiovascular morbidity and mortality.[1,2] AF has been correlated with an increased risk of stroke, systemic embolism and long term morbidity compared to individuals with sinus rhythm.[3] The highest prevalence of AF is reported in elderly as well as in patients with severe aortic stenosis, ranging between 16% and 40% in the latter.[4] In the general population, AF scales the death risk up to 1.5 and 1.9 fold in men and women, respectively.[2,5]

AF and aortic stenosis can coexist as there is a dynamic interplay and causal correlation between these pathologic processes. Especially, AF impairing atrioventricular synchrony results in irregular ventricular contraction, increased filling pressures and reduced cardiac output that may further deteriorate in case of severe aortic stenosis. On the other side, the left ventricular outflow obstruction and left ventricular hypertrophy precipitated by severe aortic stenosis,result in diastolic dysfunction, elevated left atrial pressure and further AF induction.

AF has been associated with late adverse cardiac and cerebrovascular events following surgical aortic valve replacement, such as heart failure, stroke and mortality,proven to be an independent poor prognostic factor by several surgical series.[5-7] Transcatheter aortic valve implantation (TAVI) has been considered as the appropriate treatment in high risk