Author + information
- Hongju Janet Zhang,
- Jeremy Thaden,
- Sorin Pislaru,
- Christopher Scott,
- Chayakrit Krittanawong,
- Rowlens Melduni,
- Robert McCully,
- Maurice Enriquez-Sarano,
- Jae K. Oh,
- Patricia Pellikka and
- Vuyisile Nkomo
Background: Atrial fibrillation (AF) is not uncommon in patients with severe aortic stenosis (AS). However, studies on the natural history of severe AS are based mainly on patients in sinus rhythm.
Methods: Patients with unoperated severe AS (aortic valve area ≤1.0 cm2) and left ventricular ejection fraction >=50% were identified between 2008-2012 and categorized according to absence or presence and type of AF (paroxysmal vs persistent). Clinical and echocardiographic characteristics were compared amongst the groups. Mean follow up was 5.2± 1.3 years. Long-term survival was estimated using the Kaplan-Meier method.
Results: 518 patients (age 77.2±11.4 years, 57.1% men) met inclusion criteria; 385 (74.3%) were in sinus rhythm, 59 (11.3%) had paroxysmal AF and 74 (14.2%) had persistent AF. Patient characteristics are shown in (Table 1). After adjustment for age and gender, survival were worse in paroxysmal AF (HR=1.63[1.06 to 2.51], p=0.03) and persistent AF (HR=2.04 [1.42 to 2.94], P<0.001) compared to sinus rhythm.
Conclusions: The natural history of severe AS is worse in patients with AF than in sinus rhythm despite similar symptoms. Persistent AF is associated with worse survival compared to paroxysmal AF. The presence of AF in patients with severe AS should be taken into consideration in clinical decision making and patient counseling.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Aortic Stenosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1233-027
- 2017 American College of Cardiology Foundation