Prognostic impact of atrial fibrillation in post-TAVR patients with preserved ejection fraction

Abstract Background Aortic stenosis (AS) is the most common valvular heart disease in the elderly and often associated with atrial fibrillation (AF). The impact of AF on mortality is controversial in patients with preserved ejection fraction (EF) after transcatheter aortic valve replacement (TAVR). Aims Our aim was to assess the impact of AF on survival in patients after TAVR with preserved EF in comparison with patients with sinus rhythm (SR), and to evaluate prognostic factors in AF patients. Methods In our retrospective study we enrolled patients with preserved EF ( ≥ 50%) who underwent TAVR in our tertiary cardiovascular center between 01.01.2020-01.09.2024. All-cause mortality was assessed, with a median follow-up of 17.5 months (IQR: 7.5 - 30.2 months). Results During the observed period 1511 patients underwent TAVR, of whom 947 had preserved EF. In the AF group (n= 348) patients were older (80.4±5.5 yrs vs 79.63±5.6 yrs, p=0.03) but the proportion of male sex (43% vs 39%; p=0.27) did not differ from patients with SR (n=599). There was no difference in EF (63.3±7.6% vs 64.1±7.7%, p=0.11), but the rate of paradoxical low-flow (SVi