Incidence and predictors of silent AF after transcatheter aortic valve implantation

Abstract

New onset atrial fibrillation (NOAF) post-transcatheter aortic valve implantation (TAVI) is common and is associated with adverse outcomes. However, silent AF is poorly documented in the context. This study sought to evaluate the incidence, predictive factors, and prognostic value of Silent AF post-TAVI. All the consecutive patients with TAVI were prospectively analyzed by Continuous ECG monitoring (CEM) ≥ 48 h after implantation. Silent AF was defined as asymptomatic episodes lasting at least 30 s. The population was divided into three groups: history of AF, no-AF, and silent AF. Among the 206 patients, 19 (16.1%) developed silent AF. Compared with the no-AF group, patients with silent AF shared the same clinical characteristics and cardiovascular risk factors. Procedural success and echo parameters after the device implantation were similar between groups. Left atrial volume (LAV) was significantly increased ( P < 0.001) in the silent AF group, together with pre-implantation usCRP > 3 mg/L and glucose ( P = 0.048 and P = 0.002). By multivariate analysis, Logistic euroscore and usCRP > 3 were identified as independent predictors of silent AF. In-hospital and short-term mortalities were strictly identical among groups. Our prospective study showed for the first time that silent AF is frequent after TAVI procedures. Our work suggests that usCRP could help to predict the risk of developing silent AF. However, the onset of silent AF is not associated with worse short-term prognosis.