title: Baseline Characteristics and Prognostic Implications of Pre-Existing and New-Onset Atrial Fibrillation After Transcatheter Aortic Valve Implantation: Results From the FRANCE-2 Registry.
abstract: OBJECTIVE
  The aim of this study was to determine baseline characteristics and clinical outcomes of patients with pre-existing atrial fibrillation (AF) and of patients who presented with new-onset AF after transcatheter aortic valve implantation (TAVI).
  
  
  BACKGROUND
  Little is known regarding the impact of AF after TAVI.
  
  
  METHODS
  The FRANCE-2 registry included all patients undergoing TAVI (N = 3,933) in France in 2010 and 2011. New-onset AF was defined as the occurrence of AF post-procedure in a patient with no documented history of AF.
  
  
  RESULTS
  AF was documented before TAVI in 25.8% of patients. New-onset AF was observed in 174 patients after TAVI among patients without a history of pre-existing AF (6.0%). At 1 year, the rates of all-cause death (26.5 vs. 16.6%, respectively; p < 0.001) and cardiovascular death (11.5 vs. 7.8%, respectively; p < 0.001) were significantly higher in patients with pre-existing AF compared with those without AF. Rehospitalization for worsening heart failure and New York Heart Association functional class was also higher in patients with pre-existing AF versus those without, resulting in a higher rate of combined efficacy endpoint in this group (p < 0.001). A history of stroke, surgical (nontransfemoral) approach, cardiological, and hemorrhagic procedure-related events were all independently related to the occurrence of new-onset post-procedural AF. New-onset AF in patients without pre-existing AF was associated with a higher rate of combined safety endpoint at 30 days (p < 0.001) and a higher rate of both all-cause death and combined efficacy endpoint at 1 year (p = 0.003 and p = 0.02, respectively).
  
  
  CONCLUSIONS
  Pre-existing and new-onset AF are both associated with higher mortality and morbidity after TAVI.
authors: Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France. Electronic address: rchopard@chu-besancon.fr.
authors: Romain
authors: R
authors: Chopard
authors: Department of Cardiology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil, Créteil, France.
authors: Emmanuel
authors: E
authors: Teiger
authors: Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France.
authors: Nicolas
authors: N
authors: Meneveau
authors: Department of Cardiovascular Surgery, EA3920, University Hospital Besançon, Besançon, France.
authors: Sidney
authors: S
authors: Chocron
authors: Centre Hospitalier Universitaire (CHU) de Brest, Brest, France.
authors: Martine
authors: M
authors: Gilard
authors: Department of Cardiac Surgery, University Hospital Dupuytren, Limoges, France.
authors: Marc
authors: M
authors: Laskar
authors: CHU de Rouen, Rouen, France.
authors: Hélène
authors: H
authors: Eltchaninoff
authors: Department of Cardiology, Bichat-Claude-Bernard Hospital, AP-HP, Paris, France.
authors: Bernard
authors: B
authors: Iung
authors: CHU La Pitié Salpêtrière, Paris, France.
authors: Pascal
authors: P
authors: Leprince
authors: Unité de recherche clinique en économie de la santé Ile-de-France (URC Eco), AP-HP, Hôtel-Dieu, Paris, France.
authors: Karine
authors: K
authors: Chevreul
authors: Department of Cardiovascular Surgery, CHU Lille, Lille, France.
authors: Alain
authors: A
authors: Prat
authors: University Lyon 1, Lyon, France.
authors: Michel
authors: M
authors: Lievre
authors: Division of Thoracic, Cardiac and Vascular Surgery, Rennes University Hospital, Rennes, France.
authors: Alain
authors: A
authors: Leguerrier
authors: Jacques Cartier Institute, Massy, France.
authors: Patrick
authors: P
authors: Donzeau-Gouge
authors: Clinique Pasteur, Toulouse, France.
authors: Jean
authors: J
authors: Fajadet
authors: Department of Cardiology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil, Créteil, France.
authors: Gauthier
authors: G
authors: Mouillet
authors: Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France.
authors: Francois
authors: F
authors: Schiele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D006801:Humans; D008297:Male; D010359:Patient Readmission; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: aortic stenosis; atrial fibrillation; outcomes; transcatheter aortic valve implantation