title: Clinical and prognostic implications of atrial fibrillation in patients undergoing transcatheter aortic valve implantation.
abstract: OBJECTIVE
  To study a cohort of consecutive patients undergoing transcatheter aortic valve implantation (TAVI) and compare the outcomes of atrial fibrillation (AF) patients vs patients in sinus rhythm (SR).
  
  
  METHODS
  All consecutive patients undergoing TAVI in our hospital were included. The AF group comprised patients in AF at the time of TAVI or with history of AF, and were compared with the SR group. Procedural, echocardiographic and follow-up variables were compared. Likewise, the CHA(2)DS(2)-VASC stroke risk score and HAS-BLED bleeding risk score and antithrombotic treatment at discharge in AF patients were compared with that in SR patients.
  
  
  RESULTS
  From a total of 34 patients undergoing TAVI, 17 (50%) were allocated to the AF group, of whom 15 (88%) were under chronic oral anticoagulation. Patients in the AF group were similar to those in the SR group except for a trend (P = 0.07) for a higher logistic EuroSCORE (28% vs 19%), and a higher prevalence of hypertension (82% vs 53%) and chronic renal failure (17% vs 0%). Risk of both stroke and bleeding was high in the AF group (mean CHA(2)DS(2)-VASC 4.3, mean HAS-BLED 2.9). In the AF group, treatment at discharge included chronic oral anticoagulation in all except one case, and in association with an antiplatelet drug in 57% of patients. During a mean follow-up of 11 mo (maximum 32), there were only two strokes, none of them during the peri-procedural period: one in the AF group at 30 mo and one in the SR group at 3 mo. There were no statistical differences in procedural success, and clinical outcome (survival at 1 year 81% vs 74% in AF and SR groups, respectively, P = NS).
  
  
  CONCLUSIONS
  Patients in AF undergoing TAVI show a trend to a higher surgical risk. However, in our cohort, patients in AF did not have a higher stroke rate compared to the SR group, and the prognosis was similar in both groups.
authors.affiliation: Pablo Salinas, Raúl Moreno, Luis Calvo, Santiago Jiménez-Valero, Guillermo Galeote, Angel Sánchez-Recalde, Division of Interventional Cardiology, University Hospital La Paz, 28046 Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Salinas
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno
authors.forename: Luis
authors.initials: L
authors.lastname: Calvo
authors.forename: Santiago
authors.initials: S
authors.lastname: Jiménez-Valero
authors.forename: Guillermo
authors.initials: G
authors.lastname: Galeote
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez-Recalde
authors.forename: Teresa
authors.initials: T
authors.lastname: López-Fernández
authors.forename: Sergio
authors.initials: S
authors.lastname: Garcia-Blas
authors.forename: Diego
authors.initials: D
authors.lastname: Iglesias
authors.forename: Luis
authors.initials: L
authors.lastname: Riera
authors.forename: Isidro
authors.initials: I
authors.lastname: Moreno-Gómez
authors.forename: Jose María
authors.initials: JM
authors.lastname: Mesa
authors.forename: Ignacio
authors.initials: I
authors.lastname: Plaza
authors.forename: Rocio
authors.initials: R
authors.lastname: Ayala
authors.forename: Rosa
authors.initials: R
authors.lastname: Gonzalez
authors.forename: José-Luis
authors.initials: JL
authors.lastname: López-Sendón