title: Type of Atrial Fibrillation and Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement.
abstract: BACKGROUND
  There are limited data available regarding the relationship between atrial fibrillation (AF) clinical type, oral anticoagulation (OAC) treatment, and clinical outcome after transcatheter aortic valve replacement (TAVR). The study was designed to evaluate this relationship.
  
  
  METHODS
  We analyzed data from the Rabin Medical Center TAVR registry, including 319 consecutive patients who underwent TAVR from 2008 to 2014. Patients were divided into three groups based on their history of AF: sinus rhythm (SR), paroxysmal AF (PAF), or nonparoxysmal AF (NPAF).
  
  
  RESULTS
  There were 211 (66%), 56 (18%), and 52 (16%) patients in the SR, PAF, and NPAF groups, respectively. The cumulative risk for stroke or death at 2 years was highest among patients with NPAF (38%), but similarly low in PAF (15%) and SR patients (16%, P < 0.001). By multivariate analysis, patients with NPAF demonstrated a significantly higher risk of stroke or death (HR = 2.76, 95% CI 1.63-4.66, P < 0.001), as compared with SR. In contrast, patients with PAF had a similar risk of stroke or death compared with SR (HR = 0.80, P = 0.508). Patients with NPAF not treated with OAC demonstrated an 8.3-fold (P < 0.001) increased risk of stroke or death, whereas patients with PAF not treated with OAC had a similar risk of stroke or death compared with the SR group (HR = 1.25, P = 0.569).
  
  
  CONCLUSIONS
  History of NPAF, but not PAF, is associated with a significant increased risk of stroke or death compared with sinus rhythm in patients undergoing TAVR.
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Aviv A
authors.initials: AA
authors.lastname: Shaul
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Gregory
authors.initials: G
authors.lastname: Golovchiner
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Kadmon
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Pablo
authors.initials: P
authors.lastname: Codner
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Katia
authors.initials: K
authors.lastname: Orvin
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Boris
authors.initials: B
authors.lastname: Strasberg
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Barsheshet
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality; D016896:Treatment Outcome
keywords: atrial fibrillation; oral anticoagulation; stroke; transcatheter aortic valve replacement
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