• Sang Yoon Lee, Ki Hong Choi, Taek Kyu Park, Jihoon Kim, Eun Kyoung Kim, Sung-Ji Park, Seung Woo Park, Hyeon-Cheol Gwon, Kiyuk Chang, Cheol Woong Yu, JuHan Kim, Young Jin Choi, In-Ho Chae, Jae-Hwan Lee, Jun-Hong Kim, Jong Seon Park, Won-Jang Kim, Young Won Yoon, Tae Hoon Ahn, Sang Rok Lee, Byoung Joo Choi, Tae-Hyun Yang, Cheol Ung Choi, Seung-Ho Hur, Seong-Jin Oh, Han Cheol Lee, HunSik Park, Hyo-Soo Kim, and Seung-Hyuk Choi.
• Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• Yonsei Med. J. 2023 Jul 1; 64 (7): 413422413-422.

PurposeThe incidence and prognostic implications of atrial fibrillation (AF) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) are controversial, especially for Korean patients. Furthermore, the pattern of antithrombotic therapy for these patients is unknown. The present study sought to identify the impact of AF on Korean patients undergoing TAVI and demonstrate the status of antithrombotic therapy for these patients.Materials And MethodsA total of 660 patients who underwent TAVI for severe AS were recruited from the nationwide K-TAVI registry in Korea. The enrolled patients were stratified into sinus rhythm (SR) and AF groups. The primary endpoint was all-cause death at 1-year.ResultsAF was recorded in 135 patients [pre-existing AF 108 (16.4%) and new-onset AF 27 (4.1%)]. The rate of all-cause death at 1 year was significantly higher in patients with AF than in those with SR [16.2% vs. 6.4%, adjusted hazard ratio (HR): 2.207, 95% confidence interval (CI): 1.182-4.120, p=0.013], regardless of the onset timing of AF. The rate of new pacemaker insertion at 1 year was also significantly higher in patients with AF than in those with SR (14.0% vs. 5.5%, adjusted HR: 3.137, 95%CI: 1.621-6.071, p=0.001). Among AF patients, substantial number of patients received the combination of multiple antithrombotic agents (77.8%), and the most common combination was that of aspirin and clopidogrel (38.1%).ConclusionAF was an independent predictor of 1-year mortality and new pacemaker insertion in Korean patients undergoing TAVI.© Copyright: Yonsei University College of Medicine 2023.

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