A recent research conducted by the University of Alabama and the University of Minnesota has come to a conclusion that atrial fibrillation might be a common occurrence after an aortic valve replacement (AVR) and a transcatheter aortic valve implantation (TAVI). Moreover, the research has also linked atrial fibrillation with an increase in the incident length of stay, stroke, and in-hospital mortality.

This study examined over 170,000 aortic valve replacements from 2012 to 2015. It was led by Rajat Kalra, MD.

‘The use of TAVI and aortic valve replacement will only continue to increase as the American population ages. However, we are now acknowledging that there can be many unintended effects from TAVI and surgical aortic valve replacement,’ said Rajat Kalra, who is also the study’s first author. ‘We felt strongly that we needed more data to clarify the effects of these procedures on heart rhythm, stroke and mortality for clinicians and patients who are jointly deciding how to treat aortic valve problems.’

The researchers undertook this project to evaluate the incidence of in-hospital mortality associated with new-onset atrial fibrillation after aortic valve replacement and transcatheter aortic valve implantation. Hence, they identified a total of 48,715 transcatheter aortic valve implantation hospitalizations and 122,765 aortic valve replacement hospitalizations between January 1, 2012, and September 30, 2015. The participants in the study were all 18 or older and none of them has atrial fibrillation, mitral valve repair, and congenital aortic stenosis.

A total of 24,560 hospitalizations for transcatheter aortic valve implantation with new-onset atrial fibrillation and 61,530 for aortic valve replacement with new-onset atrial fibrillation were identified. On the other hand, 24,155 hospitalizations for TAVI without new-onset atrial fibrillation and 61,235 hospitalizations for AVR without new-onset atrial fibrillation were discovered.

The results of the study showed that the ones hospitalized for TAVI and AVR with new-onset atrial fibrillation had a greater prevalence of chronic kidney disease, chronic pulmonary disease, blood transfusions, congestive heart failure, history of valve surgery, peripheral vascular disease, and coronary artery disease.  Moreover, the transcatheter aortic valve implantation patients with new-onset atrial fibrillation were at 57 percent higher risk of in-hospital mortality compared with those without new-onset atrial fibrillation. Moreover, the aortic valve replacement patients with new-onset atrial fibrillation were at 36 percent higher risk of in-hospital mortality.

The authors of the study came to the conclusion that new-onset atrial fibrillation is a very common occurrence among hospitalizations for both aortic valve replacement and a transcatheter aortic valve implantation. If you want to know more about the study, check the JAMA Internal Medicine where the study is published. The study is titled ‘Evaluation of the Incidence of New-Onset Atrial Fibrillation After Aortic Valve Replacement.’