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Prognostic Impact of New-Onset Atrial Fibrillation After Single or Double Stent Left Main Bifurcation PCI

Gianluca Rigatelli1, Marco Zuin2, Claudio Picariello3

  • 1Cardiovascular Diagnosis and Endoluminal Interventions, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|June 13, 2022
PubMed

Insights

New-onset atrial fibrillation (AF) occurred in 4.6% of patients after left main bifurcation stenting. A single stent strategy was associated with a lower risk of AF compared to double stenting, suggesting improved outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Bifurcation left main disease is a complex clinical challenge.
  • The incidence and prognostic value of new-onset atrial fibrillation (AF) following different stenting strategies for this condition remain under-investigated.

Purpose of the Study:

  • To investigate the incidence and prognostic implications of new-onset AF after single versus double stent strategies in patients with bifurcation left main disease.
  • To compare the risk of new-onset AF between single and double stenting techniques.

Main Methods:

  • Retrospective analysis of 502 patients with complex left main bifurcation disease treated between 2008 and 2018.
  • Evaluation of various stenting techniques including crossover provisional stenting, T-stenting, and Nano-inverted-T.
  • Multivariate Cox-regression analysis to assess the risk of new-onset AF adjusted for confounders.

Main Results:

  • New-onset AF occurred in 4.6% of patients during a mean follow-up of 37.1 months.
  • Patients with new-onset AF were more likely to be female, older, obese, and diabetic, and had higher rates of target lesion failure and cardiovascular death.
  • New-onset AF-free survival was better with single stent techniques compared to double stent techniques. Multivariate analysis showed a significantly lower risk of AF with single stenting (HR: 1.14) versus double stenting (HR: 1.28).

Conclusions:

  • New-onset AF after percutaneous coronary intervention for distal left main bifurcation disease has a low incidence.
  • The incidence of new-onset AF is higher following double stenting compared to single stenting.
  • New-onset AF in this patient population is associated with poorer clinical outcomes.
Abstract

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