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Funding Acknowledgements Type of funding sources: None. Backround Atrial fibrillation (AF) is associated with poor outcomes after transcatheter aortic valve implantation (TAVI).  Purpose This study aimed to investigate whether prolonged total atrial conduction time (PA-TDI) predicts the development of AF in TAVI-treated patients.  Methods A total of 307 TAVI-treated patients were enrolled. PA-TDI was defined as the duration from P wave onset on electrocardiography to peak A′ wave on tissue Doppler imaging echocardiography.  Results The study was conducted with 263 patients because 44 patients had pre-existing AF. Of 263, 47 (17.8%) had new-onset AF after TAVI procedure. Age, mortality and the frequency of PM implantation were higher in the AF group. LVEDD, LVEF, aortic gradients, and AVA were similar between AF and sinus rhythm groups; however, LVESD, LA diameter, and PA-TDI duration were increased in the AF group. In Kaplan–Meier analysis (Panel A), there was an increase in risk of AF with each incremental percentile of the PA-TDI duration. In multivariate analysis, age (p = 0.005) and PA-TDI duration (p = 0.002) were found to be independent risk factors for the development of AF after TAVI. AUC was 0.630 (p = 0.005), and the sensitivity and specificity were 70% and 51% respectively at a cut-off point of 123.5 ms for PA-TDI duration (Panel B).  Conclusion In patients treated with TAVI, post-procedural new-onset AF may lead to significant risk for morbidity and mortality. PA-TDI duration can be used for the detection of the patients with high risk of AF development. Total (n = 263) Sinus (n = 216) AF (n = 47) p value Age (years) 78.0 ± 10.8 77.5 ± 11.2 80.6 ± 8.4 0.032 Gender (F/M) 144/119 118/98 26/21 0.932 Follow-up time (months) 2 [1-77] 2 [1-77] 1 [1-51] 0.095 Death 82 (31.2%) 59 (27.3%) 23 (48.9%) 0.004 Pacemaker implantation 44 (16.7%) 32 (14.8%) 12 (25.5%) 0.075 LV end-diastolic diameter (mm) 48.2 ± 3.5 47.9 ± 5.3 49.3 ± 5.4 0.202 LV end-systolic diameter (mm) 32.2 ± 5.5 31.7 ± 5.0 35.0 ± 6.8 0.030 LV ejection fraction (%) 55.2 ± 10.9 55.4 ± 10.9 54.2 ± 11.1 0.515 LA diameter (mm) 42.9 ± 6.5 41.9 ± 6.6 44.7 ± 6.1 0.049 Peak aortic gradient (mmHg) 78.6 ± 20.5 79.2 ± 20.5 77.2 ± 20.7 0.660 Mean aortic gradient (mmHg) 46.8 ± 13.5 46.6 ± 13.2 47.2 ± 14.3 0.838 Aortic valve area (cm2) 0.73 ± 0.15 0.73 ± 0.15 0.74 ± 0.14 0.734 PA-TDI duration (ms) 127.0 ± 26.7 125.4 ± 26.2 137.0 ± 27.2 0.009 Abstract Figure.

The prediction of atrial fibrillation development in patients treated with transcatheter aortic valve implantation