scholarly journals REQUIREMENT OF PERMANENT PACEMAKER PLACEMENT AND INCIDENCE OF LEFT BUNDLE BRANCH BLOCK IN PATIENTS UNDERGOING TRANSCATHETER AORITC VALVE IMPLANTATION: A META-ANALYSIS OF EDWARDS SAPIEN VALVE VERSUS MEDTRONIC COREVALVE

2015 ◽  
Vol 65 (10) ◽  
pp. A1933
Author(s):  
Hemang B. Panchal ◽  
Neil Barry ◽  
Samit Bhatheja ◽  
Vijay Ramu ◽  
Timir Paul ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Meta Analysis ◽  
Permanent Pacemaker ◽  
Bundle Branch Block ◽  
Edwards Sapien ◽  
Pacemaker Placement ◽  
Edwards Sapien Valve ◽  
Medtronic Corevalve ◽  
Valve Implantation ◽  
Valve Versus

Abstract 17302: A Meta-Analysis of Major Adverse Cardiovascular and Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation Using Edwards SAPIEN valve versus Medtronic CoreValve for Severe Aortic Stenosis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hemang B Panchal ◽  
Neil Barry ◽  
Samit Bhatheja ◽  
Kais Albalbissi ◽  
Timir Paul
Keyword(s):  
Severe Aortic Stenosis ◽  
Meta Analysis ◽  
Transcatheter Aortic Valve ◽  
Cerebrovascular Events ◽  
Edwards Sapien ◽  
All Cause Mortality ◽  
Edwards Sapien Valve ◽  
Medtronic Corevalve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: In patients with severe aortic stenosis (AS) who are at high risk for surgery, a transcatheter aortic valve implantation (TAVI) is an emerged alternative procedure using Edwards SAPIEN valve (EV) or Medtronic CoreValve (CV). The purpose of this meta-analysis is to compare early major adverse cardiovascular and cerebrovascular events (MACCE) between EV and CV. Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched through May 2014. Seventeen studies (n=6211) comparing TAVI procedure that used EV (n=2693) and CV (n=3518) were included. End points were post-procedural all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, major bleeding and major vascular events. The odds ratio (OR) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance. Results: The studies were homogeneous for all outcomes except all-cause mortality. There was no significant difference between EV and CV for post-procedural all-cause mortality (OR: 0.82, CI: 0.6-1.13, p=0.23), cardiovascular mortality (OR: 0.7, CI: 0.41-1.2. p=0.2), myocardial infarction (OR: 1.13, CI: 0.51-2.51, p=0.76), stroke (OR: 0.97, CI: 0.66-1.42, p=0.86) (Figure), major bleeding (OR: 1.13, CI: 0.81-1.58, p=0.48) and major vascular complications (OR: 1.22, CI: 0.94-1.58, p=0.14). Conclusion: The results of our meta-analysis of 6211 patients suggest that the types of valve used to perform TAVI procedures do not affect early mortality and MACCE outcomes. Further studies are needed to evaluate long-term outcomes.

scholarly journals Permanent pacemaker dependency in patients with new left bundle branch block and new first degree atrioventricular block after transcatheter aortic valve implantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bonnie Hartrampf ◽  
David Jochheim ◽  
Julius Steffen ◽  
Thomas Czermak ◽  
Sebastian Sadoni ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Atrioventricular Block ◽  
Left Bundle Branch Block ◽  
Permanent Pacemaker ◽  
Ventricular Pacing ◽  
Bundle Branch Block ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

AbstractConduction disorders with need for permanent pacemaker (PPM) implantation remain frequent complications after transcatheter aortic valve implantation (TAVI). Up to 22% of PPM after TAVI are implanted for new onset left bundle branch block (LBBB) and atrioventricular block (AVB) I. However, clinical benefit and predictors of ventricular pacing in TAVI patients receiving PPM for this indication remain unclear. We retrospectively evaluated pacemaker interrogation data of patients who received a PPM post TAVI for new LBBB and new AVB I. The primary endpoint of this study was relevant ventricular pacing (ventricular pacing rate: Vp ≥ 1%) at the first outpatient pacemaker interrogation. Secondary endpoints were predictors for relevant ventricular pacing. At the first pacemaker interrogation (median follow up at 6.23 [2.8–14.8] months), median ventricular pacing frequency was 1.0% [0.1–17.8]. Out of 61 patients, 36 (59%) had Vp rates ≥ 1%. Patients with frequent ventricular pacing showed longer QRS duration (155 ms ± 17 ms vs. 144 ms ± 18 ms, p = 0.018) at the time of PPM implantation and were less likely treated with a balloon-expandable Edwards Sapiens Valve (39% vs. 12%, p = 0.040). Our findings suggest that the majority of patients with new LBBB and new AVB I after TAVI show relevant ventricular pacing rates at follow up. Further prospective studies are necessary to identify patients at higher risk of pacemaker dependency.

scholarly journals Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis

2021 ◽  
Vol 10 (12) ◽  
pp. 2719
Author(s):  
Justine M. Ravaux ◽  
Michele Di Mauro ◽  
Kevin Vernooy ◽  
Silvia Mariani ◽  
Daniele Ronco ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Meta Analysis ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Bundle Branch Block ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
The Impact

Data regarding the impact of infra-Hisian conduction disturbances leading to permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) remain limited. The aim of this study was to determine the impact of right and/or left bundle branch block (RBBB/LBBB) on post-TAVI PPI. We performed a systematic literature review to identify studies reporting on RBBB and/or LBBB status and post-TAVI PPI. Study design, patient characteristics, and the presence of branch block were analyzed. Odds ratios (ORs) with 95% CI were extracted. The final analysis included 36 studies, reporting about 55,851 patients. Data on LBBB were extracted from 33 studies. Among 51,026 patients included, 5503 showed pre-implant LBBB (11.9% (10.4%–13.8%)). The influence of LBBB on post-TAVI PPI was not significant OR 1.1474 (0.9025; 1.4588), p = 0.2618. Data on RBBB were extracted from 28 studies. Among 46,663 patients included, 31,603 showed pre-implant RBBB (9.2% (7.3%–11.6%)). The influence of RBBB on post-TAVI PPI was significant OR 4.8581 (4.1571; 5.6775), p < 0.0001. From this meta-analysis, the presence of RBBB increased the risk for post-TAVI PPI, independent of age or LVEF, while this finding was not confirmed for patients experimenting with LBBB. This result emphasizes the need for pre-operative evaluation strategies in patient selection for TAVI.

New onset left bundle branch block after transcatheter aortic valve implantation and the effect on long-term survival – a UK wide experience

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.S Arri ◽  
A Myat ◽  
I Malik ◽  
N Curzen ◽  
A Baumbach ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Left Bundle Branch Block ◽  
Left Ventricular ◽  
Bundle Branch Block ◽  
Transcatheter Aortic Valve ◽  
All Cause Mortality ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
New Onset

Abstract Introduction New onset left bundle branch block (LBBB) is the most common conduction disturbance associated with transcatheter aortic valve implantation (TAVI). It has been shown to adversely affect cardiac function and increase re-hospitalisation, although its impact on mortality remains contentious. Methods We conducted an observational cohort analysis of all TAVI procedures performed by 13 heart teams in the United Kingdom from inception of their structural programmes until 31st July 2013. The primary outcome was 1-year all-cause mortality. Secondary outcomes included left ventricular ejection fraction (LVEF) at 30 days and need for a post-TAVI permanent pacemaker (PPM). Results 1785 patients were eligible for inclusion to the study. The primary analysis cohort was composed of 1409 patients with complete electrocardiographic (ECG) data pre- and post-TAVI. Pre-existing LBBB was present in 200 (14.2%) patients. New LBBB occurred in 323 (22.9%) patients post TAVI, which resolved in 99 (7%) patients prior to discharge. A balloon-expandable device was implanted in 968 (69%) patients, whilst 421 (30%) patients received a self-expandable valve. New LBBB was observed in 120 (12.4%) and 192 (45.6%) patients receiving a balloon- or self-expandable prosthesis respectively. Overall 1-year all-cause mortality post TAVI was 18.7%. New onset LBBB was not associated with an increase in 1-year all-cause mortality (p=0.416). Factors that were associated with mortality included an increasing logistic EuroScore (p=0.05), history of previous balloon aortic valvuloplasty (p=0.001), renal impairment (p=0.003), previous myocardial infarction with pre-existing LBBB (p=0.028) and atrial fibrillation (p=0.039). Lower baseline peak and mean AV gradients were also associated with greater mortality at 1 year (p=0.001), likely reflecting underlying left ventricular dysfunction. In the majority of patients, LVEF remained unchanged following TAVI. Interestingly, the presence or absence of new onset LBBB did not affect LVEF improvement at 30 days. 10% of patients required a PPM post TAVI. Predictors of PPM included new LBBB (OR 2.6, p&lt;0.001), pre-TAVI left ventricular systolic impairment (OR 1.2, p=0.037), a self-expandable device (p&lt;0.001), and pre-existing RBBB (OR 4.0, p&lt;0.001). Conclusions These findings suggest that new onset LBBB post TAVI does not increase mortality at 1 year or adversely affect LVEF at 30 days. Funding Acknowledgement Type of funding source: None

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