We analyzed all 57,050 cases of TF-TAVR between 2008 and 2016 in Germany, of which 44.2% had AF. Patients with AF were at higher risk for unfavorable in-hospital outcome after TAVR. Including all baseline characteristics for a risk-adjusted comparison, AF was an independent risk factor for in-hospital mortality after TAVR. Among patients with AF, the occurrence of post-procedural stroke or moderate to major bleeding substantially increased in-hospital mortality. However, the strongest independent predictor for in-hospital mortality among patients with AF was severe bleeding (OR 18.00, 95%CI 15.22-21.30, P<0.001). The present study demonstrates that the incidence of bleeding defines the in-hospital outcome of patients with AF after TF-TAVR. The peri-procedural phase demands particular care in bleeding prevention, but is still underinvestigated.
Lother et al. Bleeding Complications Drive In-Hospital Mortality of Patients with Atrial Fibrillation after Transcatheter Aortic Valve Replacement. Thromb Haemost. 2020;DOI: 10.1055/s-0040-1715833