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Cardiovascular risk in patients with advanced aortic stenosis (AS) remains substantial following treatment with balloon aortic valvuloplasty (BAV). While concomitant atrial fibrillation or flutter (AF/AFL) is frequent among patients with AS, the impact of AF/AFL on outcomes following BAV remains unknown.
We conducted a retrospective review of consecutive patients undergoing elective BAV from 1/2010 to 12/2012 at our center. Presence of AF/AFL included documented prior history or electrocardiographic evidence prior to index procedure. We assessed in-hospital outcomes and 1 year mortality, according to presence or absence of AF/AFL. All events were adjudicated by an independent committee.
Out of 339 patients underwent BAV, 137 patients (40.4%) had AF/AFL. AF/AFL patients were older, more commonly males, with history of stroke, and use of warfarin on admission. In-hospital (6.6% vs. 4%, p=0.03) and 1-year all-cause mortality (36.1% vs. 23.2%, p= 0.02) were significantly higher in patients with AF/AFL, driven mostly by cardiovascular death. However, the in-hospital incidence of major bleeding (BARC≥3), as well as the composite endpoints of MACE did not differ significantly between the two groups.
The presence of AF/AFL is associated with significantly increased risk for mortality in BAV patients. Whether or not AF/AFL is a marker of higher-risk patients or a direct mediator of excess risk in this setting merits prospective investigation.