New Onset Atrial Fibrillation After Aortic Valve Replacement: A Comparison of Transfemoral Transapical, Transaortic and Surgical Approaches

Transaortic transcatheter aortic valve implantation: Results of the Polish arm of the ROUTE registry

“…We observed no major strokes in our group of patients and only 2 patients suffered from transient ischemia. The most prevalent complication was the development of AV block with a requirement for pacemaker implantation, which is in agreement with previous studies regarding TAo-TAVI [20,21]. In contrast, for the TA approach, this complication has been shown to occur less frequently [21][22][23], indicating that positioning of the THV may be deeper when the TAo route is used [24,25].…”

Rates of vascular access use in transcatheter aortic valve replacement: A look into the next generation

“…Despite a high burden of atrial fibrillation in the post TAVR population, there was a significant increase in patients who underwent nonfemoral access via TA or TAo approach. Incidence of atrial fibrillation was 53% in TA‐TAVR, 33% in TAo‐TAVR, and 14% in TF‐TAVR . Saia et al published a study in which the incidence of acute kidney was worse in nonfemoral cases.…”

Impact of pre‐existing or new‐onset atrial fibrillation on 30‐day clinical outcomes following transcatheter aortic valve replacement: Results from the BRAVO 3 randomized trial

“…The pathophysiology of new‐onset AF post TAVR has been linked with increased left atrial stress from LV dysfunction, and local inflammatory processes from the TAVR procedure inciting ectopic atrial activity . However, the most important risk factor for new‐onset AF is TAVR access, with significantly greater risk from nontransfemoral (non‐TF) approaches . This is hypothesized to be due to nonpercutaneous surgical access, postoperative access site pain and complications including infection triggering inflammatory pathways .…”

“…However, the most important risk factor for new‐onset AF is TAVR access, with significantly greater risk from nontransfemoral (non‐TF) approaches . This is hypothesized to be due to nonpercutaneous surgical access, postoperative access site pain and complications including infection triggering inflammatory pathways . While balloon expandable valves and post dilation are linked with increased risk of cerebral embolization , intuitively this risk may be compounded in the setting of AF.…”