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Updated: Jul 30, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Prediction of New-Onset Atrial Fibrillation in Transcatheter Aortic Valve Implantation
Ugur Nadir Karakulak1, Levent Sahiner1, Ergun Baris Kaya1
1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara Turkey.
Background:
This study investigates the association between prolonged total atrial conduction time and the development of new-onset atrial fibrillation (AF) following transcatheter aortic valve implantation (TAVI).
Methods:
We enrolled 307 patients who underwent TAVI. Total atrial conduction time was calculated as the time between the onset of the P wave on the electrocardiography and the peak of the a' wave velocity (PA-TDI duration) on tissue Doppler imaging echocardiography.
Results:
A total of 263 patients were analyzed after excluding 44 with pre-existing AF. Of these 263 patients, 47 (17.8%) experienced new-onset AF after the TAVI procedure. The new-onset AF group had an older median age (80.6 vs. 77.5 years) and a higher incidence of paravalvular aortic regurgitation than those without AF (none 29.8%, mild 46.8%, moderate 23.4%). The new-onset AF group had increased end-systolic diameter (35.0 vs. 31.7 mm, p = 0.03), left atrial diameter (44.7 vs. 41.9 mm, p = 0.049), and PA-TDI duration (137.0 vs. 125.4 ms, p = 0.009). Older age, the presence of paravalvular aortic regurgitation, and prolonged PA-TDI duration were independently associated with new-onset AF in multivariate analysis. The optimal cut-off value for PA-TDI duration was 123.5 ms.
Conclusions:
AF in patients treated with TAVI may pose significant risks for morbidity and mortality. PA-TDI duration, a readily available echocardiographic parameter, can detect patients with a high risk of new-onset AF.
