{"doi":"10.1007/s40119-022-00262-w","title":"Patients with Atrial Fibrillation Benefit from SAVR with Surgical Ablation Compared to TAVR Alone","abstract":"INTRODUCTION: In patients with preoperative atrial fibrillation (AF) undergoing aortic valve replacement, the addition of surgical ablation to surgical aortic valve replacement (SAVR-SA) is efficacious and a Class I guideline. We hypothesized that this subgroup may benefit from SAVR-SA compared to transcatheter aortic valve replacement (TAVR) alone. METHODS: Medicare beneficiaries with persistent non-valvular AF who underwent SAVR-SA or TAVR alone between 2012 and 2018 were included. Patients with high-risk surgical comorbidities were excluded. Groups were matched using inverse probability weighting. The primary outcome was all-cause mortality. Secondary outcomes were stroke, transient ischemic attack, permanent pacemaker implantation, bleeding, rehospitalization for atrial arrhythmias, and rehospitalization for heart failure. Kaplan-Meier estimates and Cox proportional-hazards regression were used to compare outcomes. Outcomes were adjusted for variables with a standardized mean difference greater than 0.1. RESULTS: Of 439,492 patients who underwent aortic valve replacement, 2591 underwent SAVR-SA and 1494 underwent TAVR alone. Weighting resulted in adequately matched groups. Compared to TAVR alone, SAVR-SA was associated with a significant reduction in all-cause mortality (HR 0.65, 95% CI 0.53-0.79), permanent pacemaker implantation (HR 0.62, 95% CI 0.44-0.87), bleeding (HR 0.63, 95% CI 0.39-1.00), and rehospitalization for heart failure (HR 0.49 (0.36-0.65). There was no difference in the incidence of stroke (HR 1.07, 95% CI 0.74-1.54), transient ischemic attack (HR 1.05, 95% CI 0.75-1.47), or rehospitalization for atrial arrhythmia. CONCLUSION: Select patients with persistent non-valvular AF may benefit from SAVR-SA compared to TAVR alone.","journal":"Cardiology and Therapy","year":2022,"id":262987,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9569,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":445599,"name":"Zehang Chen","orcid":"0009-0008-0880-2151","position":1,"is_corresponding":false},{"id":474506,"name":"Jason J. Han","orcid":"0000-0001-9288-3725","position":2,"is_corresponding":false},{"id":343797,"name":"Benjamin Smood","orcid":"0000-0002-8667-6591","position":3,"is_corresponding":false},{"id":775247,"name":"Akhil Rao","orcid":"0000-0002-4489-5622","position":4,"is_corresponding":false},{"id":768660,"name":"Fabliha Khurshan","orcid":null,"position":5,"is_corresponding":false},{"id":255157,"name":"Siddharth Yarlagadda","orcid":"0000-0001-8148-9167","position":6,"is_corresponding":false},{"id":474508,"name":"Amit Iyengar","orcid":"0000-0001-7689-1733","position":7,"is_corresponding":false},{"id":474507,"name":"John J. Kelly","orcid":"0000-0002-9690-3137","position":8,"is_corresponding":false},{"id":881532,"name":"Joshua C. Grimm","orcid":null,"position":9,"is_corresponding":false},{"id":775250,"name":"Marisa Cevasco","orcid":"0000-0002-0075-2574","position":10,"is_corresponding":false},{"id":243355,"name":"Joseph E. Bavaria","orcid":"0000-0001-7145-0453","position":11,"is_corresponding":false},{"id":243353,"name":"Nimesh D. Desai","orcid":"0000-0002-4456-5674","position":12,"is_corresponding":false},{"id":474504,"name":"William L. Patrick","orcid":"0000-0001-6803-6817","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T00:26:29.321923Z","pmid":"35357666","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}