E-18 | Atrial Fibrillation and Transcatheter Aortic Valve Replacement: The Chicken or the Egg?

: Atrial fibrillation (AFib) is prevalent in patients undergoing transcatheter aortic valve replacement (TAVR) and has been associated with worse outcomes. We assessed the in-hospital outcomes of TAVR patients in a large contemporary database. : Data was collected on all patients that underwent TAVR between 2021-2022 at 4 New York metropolitan area hospitals and entered into the STS ACC TAVR registry for quality assurance. In-hospital bleeding outcomes were defined by the VARC-3 update. Mann-Whitney U tests for continuous variables and Chi-square tests for categorical variables were utilised. A p-value <0.05 was considered statistically significant. A total of 1,796 patients underwent TAVR, 442 pts had known AFib prior to the procedure. Patients with AFib were older and had more comorbid conditions compared with patients without AFib (Table). In-hospital outcomes was characterized by higher ischemic stroke and mortality rates in the AFib group. Bleeding and vascular complications were similar in both groups. : In a contemporary database of AFib patients undergoing TAVR: 1) AFib patients were older and had more comorbid conditions; 2) AFib patients had higher rates of in-hospital ischemic stroke; 3) Bleeding and vascular access complications were similar to non AFib patients; and 4) In-hospital mortality was higher in AFib patients. Whether AKI is a marker of a sicker population or a prognosticator of poor outcomes remains to be determined nonetheless, these findings underscore the need for a careful peri-procedural anticoagulation in these patients. Propensity matching will be presented at the meeting.