Background: Transcatheter aortic valve implantation (TAVI) is performed in patients with severe aortic stenosis who are not a candidate for surgical aortic valve replacement (SAVR). New onset post-operative atrial fibrillation is a common complication after SAVR and has also been reported after TAVI in clinical trials and registries. The objective of this meta-analysis is to compare incidence of post-procedural new onset atrial fibrillation in patients who underwent TAVI versus SAVR.
Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched through January 2015. Six studies (n= 1173) which reported incidence of post-procedural new onset atrial fibrillation comparing TAVI (n=596) and SAVR (n=577) were included. End point was post-procedural new onset atrial fibrillation. The odds ratio (OR) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance.
Results: The studies were homogeneous. Incidence of post-procedural new onset atrial fibrillation was significantly higher in SAVR group compared to TAVI group (OR: 3.10, CI: 2.20-4.35, p<0.00001) (Figure 1).
Conclusion: The results of this meta-analysis of 1173 patients suggest that SAVR is associated with higher incidence of post-procedural new onset atrial fibrillation compared to TAVI procedure. This complication may lead to significant morbidity due to need of long term anticoagulation as well as possibility of tachycardia induced cardiomyopathy; however, randomized controlled studies are needed to further evaluate the long-term clinical outcomes.