{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:39:52Z","timestamp":1791855592804,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T00:00:00Z","timestamp":1580860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010129","name":"Maud Kuistilan Muistos\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004756","name":"Emil Aaltosen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004756","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005633","name":"Syd\u00e4ntutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preoperative permanent atrial fibrillation (AF) is associated with impaired outcome after surgical aortic valve replacement (SAVR). The impact of preoperative paroxysmal AF, however, has remained elusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We assessed the impact of preoperative paroxysmal AF on outcome in patients undergoing SAVR with bioprosthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 666 patients undergoing isolated AVR with a bioprosthesis were included. Survival data was obtained from the national registry Statistics Finland. Patients were divided into three groups according to the preoperative rhythm: sinus rhythm (n = 502), paroxysmal AF (n = 90), and permanent AF (n = 74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in the sinus rhythm and paroxysmal AF groups did not differ with respect to age (<jats:italic>P<\/jats:italic> = .484), gender (<jats:italic>P<\/jats:italic> = .402) or CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score (<jats:italic>P<\/jats:italic> = .333). At 12\u2010month follow\u2010up, AF was present in 6.2% of sinus rhythm patients and in 42.4% of paroxysmal AF patients (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). During follow\u2010up, incidence of fatal strokes in the paroxysmal AF group was higher compared to sinus rhythm group (1.9 vs 0.4 per 100 patient\u2010years, HR 4.4 95% Cl 1.8\u201011.0, <jats:italic>P<\/jats:italic> = .001). Cardiovascular mortality was higher in the paroxysmal AF group than in the sinus rhythm group (5.0 vs 3.0 per 100 patient\u2010years, HR 1.70 95% CI 1.05\u20102.76, <jats:italic>P<\/jats:italic> = .03) and equal to patients in the permanent AF (5.0 per 100 patient\u2010years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients undergoing SAVR with bioprosthesis and history of paroxysmal AF had higher risk of developing permanent AF, cardiovascular mortality and incidence of fatal strokes compared to patients with preoperative sinus rhythm. Life\u2010long anticoagulation should be considered in patients with a history of preoperative paroxysmal AF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23329","type":"journal-article","created":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T12:50:36Z","timestamp":1580907036000},"page":"401-409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preoperative paroxysmal atrial fibrillation predicts high cardiovascular mortality in patients undergoing surgical aortic valve replacement with a bioprosthesis: CAREAVR study"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8745-9065","authenticated-orcid":false,"given":"Maunu","family":"Nissinen","sequence":"first","affiliation":[{"name":"Heart Center Kuopio University Hospital and University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joonas","family":"Lehto","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8186","authenticated-orcid":false,"given":"Fausto","family":"Biancari","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"},{"name":"Department of Surgery Oulu University Hospital  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomo","family":"Nieminen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Internal Medicine South Karelia Central Hospital  Lappeenranta Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Malmberg","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Yannopoulos","sequence":"additional","affiliation":[{"name":"Department of Surgery Oulu University Hospital  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6776-1504","authenticated-orcid":false,"given":"Samuli","family":"Salmi","sequence":"additional","affiliation":[{"name":"Heart and Lung Center Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-568X","authenticated-orcid":false,"given":"Juhani K. E.","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0908-3741","authenticated-orcid":false,"given":"Tuomas","family":"Kiviniemi","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"},{"name":"Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha E. K.","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Heart Center Kuopio University Hospital and University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1995.00430050045005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.02.030"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S47385"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivs538"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs469"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.067"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.09.021"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12345"},{"key":"e_1_2_8_10_1","first-page":"136","article-title":"Prediction of paroxysmal atrial fibrillation after aortic valve replacement in patients with aortic stenosis: identification of potential risk factors","volume":"12","author":"Orlowska\u2010Baranowska E","year":"2003","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq278"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.04.004"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.027"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.12.023"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivu128"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2012.08.016"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-016-0804-3"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.03.067"},{"key":"e_1_2_8_19_1","article-title":"Performance of CHA2DS2\u2010VASc score for stroke prediction after surgical aortic valve replacement","author":"Kiviniemi T","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH16-01-0007"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.107"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.01.371"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/24748706.2017.1419327"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.23329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.23329","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T03:11:42Z","timestamp":1693969902000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.23329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,5]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1002\/clc.23329"],"URL":"https:\/\/doi.org\/10.1002\/clc.23329","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,5]]},"assertion":[{"value":"2019-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}