About 8% of patients undergoing transcatheter aortic valve replacement (TAVR) develop new-onset atrial fibrillation. Development of new-onset atrial fibrillation is associated with a worse prognosis.
Patient selection: transcatheter aortic valve replacement, without atrial fibrillation
Risk factors for new-onset atrial fibrillation:
(1) vascular access other than transfemoral
(2) high Society of Thoracic Surgeons predicted risk of mortality (PROM) score
(3) female
(4) older age (with considerable overlap, using >= 85 years in the implementation)
(5) NYHA class III or IV heart failure
(6) severe COPD
Protective factor for new-onset atrial fibrillation:
(1) pacemaker
Risk factors for complications:
(1) discharge without anticoagulation
A patient who develops new-onset atrial fibrillation should have more aggressive management including the start of anticoagulation if possible.
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