Abstract
Although preoperative atrial fibrillation (AF) is common in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation, how AF affects outcomes remains unclear. We analyzed our single-center experience with CF-LVAD implantation to determine whether preoperative AF was associated with inferior outcomes. From November 2003 through March 2016, 526 patients with chronic heart failure underwent implantation with the HeartMate II (HMII; n = 403) or HeartWare VAD (HVAD; n = 123). We identified 229 patients (165 HMII, 65 HVAD) who had preoperative AF and compared them with non-preoperative AF patients regarding the incidence of postoperative stroke, as well as long-term survival. After implantation, 139 patients had a stroke (78 non-preoperative AF patients [26.2%], 61 preoperative AF patients [26.6%]; p = 0.84). The rate of events per patient-year was 0.19 in non-preoperative AF patients and 0.22 in preoperative AF patients (p = 0.84). Survival was not significantly different between the two groups (p = 0.60). In Cox regression, preoperative AF was not associated with postoperative stroke (odds ratio: 1.13; 95% confidence interval [CI]: 0.74-1.74; p = 0.55) or survival (hazard ratio: 0.93; 95% CI: 0.71-1...Continue Reading
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Apr 26, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Teruhiko ImamuraYoshiki Sawa
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