AI Article Synopsis
- - The study aimed to evaluate the occurrence and impact of early (in-hospital) and late (post-discharge) atrial fibrillation or flutter (POAF) in patients with severe aortic stenosis undergoing transcatheter (TAVR) or surgical (SAVR) valve replacement.
- - Results showed that early POAF was more common after SAVR (36.6%) than TAVR (4.3%), while late POAF occurred in 7.0% of patients within a year post-surgery.
- - The findings indicated that early POAF did not predict late POAF or worse outcomes like death, stroke, or rehospitalization, whereas late POAF significantly increased the risk for
Article Abstract
Objectives: The aim of this study was to assess the incidence and prognostic impact of early and late postoperative atrial fibrillation or flutter (POAF) in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR).
Background: There is an ongoing controversy regarding the incidence, recurrence rate, and prognostic impact of early (in-hospital) POAF and late (postdischarge) POAF in patients with AS undergoing TAVR or SAVR.
Methods: In the PARTNER (Placement of Aortic Transcatheter Valve) 3 trial, patients with severe AS at low surgical risk were randomized to TAVR or SAVR. Analyses were performed in the as-treated population excluding patients with preexistent atrial fibrillation or flutter.
Results: Among 781 patients included in the analysis, early POAF occurred in 152 (19.5%) (18 of 415 [4.3%] and 134 of 366 [36.6%] following TAVR and SAVR, respectively). Following discharge, 58 new or recurrent late POAF events occurred within 1 year following the index procedure in 55 of 781 patients (7.0%). Early POAF was not an independent predictor of late POAF following discharge (odds ratio: 1.04; 95% CI: 0.52-2.08; P = 0.90). Following adjustment, early POAF was not an independent predictor of the composite outcome of death, stroke, or rehospitalization (hazard ratio: 1.10; 95% CI: 0.64-1.92; P = 0.72), whereas late POAF was associated with an increased adjusted risk for the composite outcome (hazard ratio: 8.90; 95% CI: 5.02-15.74; P < 0.0001), irrespective of treatment modality.
Conclusions: In the PARTNER 3 trial, early POAF was more frequent following SAVR compared with TAVR. Late POAF, but not early POAF, was significantly associated with worse outcomes at 2 years, irrespective of treatment modality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcin.2021.05.026 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ondansetron use is associated with increased risk of acute kidney injury in ICU patients following cardiac surgery: a retrospective cohort study.
Front Pharmacol
December 2024
Department of Pharmacy, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Background: Ondansetron is widely used for prophylaxis of postoperative nausea and vomiting (PONV) after general anesthesia. While previous studies have emphasized its early use, the effects of ondansetron in intensive care unit (ICU) patients following cardiac surgery remain unclear. This study investigates the association between postoperative ondansetron exposure and the risk of mortality, acute kidney injury (AKI), and postoperative atrial fibrillation (POAF) in ICU patients after cardiac surgery.
View Article and Find Full Text PDFAim: To study the factors that influence the occurrence of postoperative atrial fibrillation (POAF) in patients with chronic ischemic heart disease (IHD) after coronary artery bypass grafting (CABG).
Material And Methods: This single-center prospective observational non-randomized study included 152 patients with chronic IHD. Mean age of patients was 64.
Cerebrovascular events after perioperative paroxysmal atrial fibrillation in patients undergoing aortic valve replacement.
Minerva Cardiol Angiol
November 2024
Department of Cardiac Surgery, Mater Dei Hospital, Msida, Malta.
Article Synopsis
- Postoperative atrial fibrillation (POAF) is common after aortic valve replacement (AVR), but this study found no significant long-term risk of stroke in patients with POAF compared to those without.
- The research analyzed 831 patients over a median of 6.5 years, focusing on those with bioprosthetic valves who were not on anticoagulation.
- Although patients with a history of atrial fibrillation showed a higher risk of perioperative stroke, the findings suggest that POAF alone does not exacerbate long-term stroke risk in AVR patients.
Comparison of Amiodarone Loading Dosage in the Treatment of Postoperative Atrial Fibrillation: High Versus Standard Dose Treatment.
Curr Vasc Pharmacol
November 2024
Department of Social Work, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
Article Synopsis
- Postoperative atrial fibrillation (POAF) can lead to serious complications like stroke and death, and a rhythm-control strategy is generally better than rate control for stable patients.
- This study aimed to assess if a higher loading dose of intravenous amiodarone could more effectively restore normal heart rhythm in patients experiencing POAF following noncardiac surgery.
- Results showed that patients receiving the higher amiodarone dosage restored sinus rhythm faster (about 2.4 hours) compared to those on the standard dosage (around 8.7 hours), though both groups achieved similar results by the 24-hour mark.
Determinants and impact of postoperative atrial fibrillation burden during 2.5 years of continuous rhythm monitoring after cardiac surgery: Results from the RACE V prospective cohort study.
Heart Rhythm
August 2024
Department of Physiology, Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands; Department of Cardiology, Heart and Vascular Centre Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address:
Article Synopsis
- Early postoperative atrial fibrillation (POAF) is common after cardiac surgery and can lead to more frequent late-POAF recurrences, yet its impact on long-term outcomes isn't well understood.
- This study aimed to understand the extent of POAF burden in the early postoperative period and its relationship with late-POAF recurrences over 2.5 years of continuous monitoring after surgery.
- Results indicated that higher early-POAF burden, particularly the duration of the longest POAF episode, is significantly linked to an increased risk of experiencing late-POAF episodes, suggesting early POAF monitoring could help predict long-term outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!