Influence of Atrial Fibrillation on the Diagnosis of Severe Low-Flow Aortic Stenosis

Averaging multiple beats can mask the diagnosis of severe aortic stenosis.

Low-flow severe aortic stenosis (AS) can be difficult to diagnose, particularly in the setting of atrial fibrillation (AF) in which multiple beats (5 in the current study) of varying cycle lengths with different gradients are averaged. In this observational, single-center study, investigators examined the diagnosis and outcomes of 1541 patients (mean age, 76 years; 47% women) with severe AS (aortic valve area ≤1 cm² and normal ejection fraction) based on the presence of high (≥40 mm Hg) or low (<40) gradients with and without AF.

Compared with severe-AS patients with sinus rhythm and high gradients, the patients with AF — both the high- and low-gradient groups — had lower mean gradient and stroke volume at baseline. During a median of 2.1 ye…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)