AFib After TAVI Increases Mortality Risk

MedicalResearch.com Interview with:
Lior Yankelson, MD PhD
Tel Aviv Medical Center

MedicalResearch: What are the main findings of the study?

Dr. Yankelson: The main findings of the study are that new onset atrial fibrillation after TAVI does not confer a significant risk for mortality , and confers somewhat increased risk for stroke. The latter issue is expected to become less significant with new technological advancements coming into the market, such as lower profile devices and emboli protection both mechanical and pharmaceutical. The more significant and alarming finding is that patients with atrial fibrillation have more than 4 fold risk for death at 1 year post TAVI compared to patients without afib. This is very significant and raises questions regarding the benefit for the procedure in these patients.

MedicalResearch: What was most surprising about the results?

Dr. Yankelson: The surprising thing is the extent of risk that afib confers – truly important factor.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Yankelson: Clinicians should understand that when deciding or advising about procedures to patients with atrial fibrillation, they should remember that this is not an isolated cardiac rhythm disorder, but rather a “red flag” for a patient at significant greater risk for a complication or death.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Yankelson: We should put much more effort into understanding the implications of atrial fibrillation as a systemic sign, and also invest more in actively pursuing and diagnosing atrial fibrillation. In addition, we should look for intelligent ways to incorporate atrial fibrillation into risk scores we use in practice.

Citation:

Atrial Fibrillation, Stroke and Mortality Rates Following Transcatheter Aortic Valve Implantation

Yankelson, Lior et al.
American Journal of Cardiology