The presence of atrial fibrillation (AF) after transcatheter aortic valve replacement (TAVR) may be associated with changes in left ventricular (LV) mass index, according to a prospective observational study published in Clinical Research in Cardiology.

Patients (N=213) with severe symptomatic aortic stenosis undergoing TAVR at a single center in Germany between 2015 and 2020 were recruited for this study. AF was defined as previously identified (n=88) or newly diagnosed by 12-lead electrocardiograph directly after TAVR (n=7). Clinical outcomes and adverse events were assessed through 36 months.

Patients with vs without AF were significantly older (82±7 vs 79±8 years, respectively; P =.02), and a greater percentage had chronic renal failure (57% vs 39%, respectively; P =.02), prescribed beta-blockers (83% vs 67%, respectively; P =.007), had greater left atrial diameter (48±11 vs 43±7 mm, respectively; P =.004), right ventricular diameter (33±4 vs 31±4 mm, respectively; P =.02), higher moderate mitral regurgitation (21% vs 12%, respectively; P =.07), moderate tricuspid regurgitation (16% vs 2%, respectively; P <.001), lower aortic valve mean gradient (41±13 mm Hg vs 45±14 mm Hg, respectively; P =.02), and tricuspid annular plane systolic excursion (20±4 vs 22±5 mm, tricuspid a; P =.003). During TAVR no procedural differences were observed on the basis of AF.

At follow-up, patients with sinus rhythm exhibited increased relative change to LV mass index (–9±29%) compared with patients who had AF (–2±28%; P =.04). LV ejection fraction was lower among patients with vs without AF (52±11% vs 56±7%, respectively; P =.004) and LV end-diastolic diameter was greater (47±8 mm vs 44±6 mm, respectively; P =.003).

Change in LV mass index was associated with AF (ß, 0.076; 95% CI, 0.001-0.150; P =.04) and baseline LV mass index (ß, –0.002; 95% CI, –0.002 to –0.001; P <.001).

Atrial Fibrillation After TAVR May Be Associated With Changes in LVMI

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