scholarly journals 607 Comparison of incidence and predictors of new left bundle branch block and permanent pacemaker implantation in a large multicentre contemporary TAVI registry using the Evolut R/pro system vs. the accurate neo valve

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Alessandro Sticchi ◽  
Francesco Gallo ◽  
Vincenzo De Marzo ◽  
Kim Won-keun ◽  
Arif A Khokhar ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Heart Valves ◽  
New Left ◽  
Pacemaker Implantation ◽  
Multivariate Regression Analysis ◽  
Permanent Pacemaker ◽  
Bundle Branch Block ◽  
Permanent Pacemaker Implantation ◽  
Conduction Disorders ◽  
The Impact

Abstract Aims Conduction disorders and permanent pacemaker implantation (PPI) continue to be an important issue in patients who undergo transcatheter aortic valve implantation (TAVI). The aim of this study was to investigate the incidence and clinical outcomes of new left bundle branch block (LBBB) and PPI after TAVI in a comparison between two self-expandable supra-annular transcatheter valves. Methods and results We report the data from an international, retrospective registry including 3862 consecutive patients who underwent TAVI with two self-expanding transcatheter heart valves (Medtronic Evolut R/PRO and Boston ACURATE neo). Patients with pre-existing left or right bundle branch block, any atrioventricular blocks or previous pacemaker implantation were excluded. Finally, we performed a propensity score matched analysis (PSM) to match the patients and overcome pre-procedural differences reaching 427 couples. New-onset Left Bundle Branch Block (LBBB) occurred with a rate of 13.1% (56/427) in the ACURATE group and 18.7% (80/427) in the Evolut group (P = 0.031). The incidence of new permanent pacemaker implantation was 16.4% (70/427) in the Evolut group and 6.8% (29/427) in the ACURATE group, respectively (P < 0.001). In the multivariate regression analysis, we found the valve recapture [odds ratio (OR): 4.66, 95% confidence interval (CI): 1.08–23.75, P = 0.042] as significant predictors for LBBB, and male sex (OR: 1.59, CI: 1.03–2.46, P = 0.036), ACURATE valve (OR: 0.34, CI: 0.20–0.57, P < 0.001) and post-procedure LBBB (OR: 4.38, CI: 2.78–6.85, P < 0.001) for PPI. Conclusions In our large multi-centre contemporary cohort of patients, new LBBB and PPI occurred more frequently in patients following TAVI with Evolut R/PRO vs. ACURATE valve. However, the choice of the valve seemed to influence only the rate of pacemaker implantation and not the incidence of new LBBB. Further data is required to clarify the impact of valve design on conduction abnormalities.

scholarly journals Long-term outcome after TAVI and the impact of new left bundle branch block or pacemaker implantation on survival

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P5424-P5424
Author(s):  
R. Hoffmann ◽  
K. Brehmer ◽  
R. Herpertz ◽  
N. Marx ◽  
R. Autschbach ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
New Left ◽  
Pacemaker Implantation ◽  
Term Outcome ◽  
Bundle Branch Block ◽  
Long Term Outcome ◽  
The Impact

scholarly journals Long-term Outcome after TAVI and the Impact of New Left Bundle Branch Block or Need for Pacemaker Implantation on Survival

2013 ◽  
Vol 62 (18) ◽  
pp. C36
Author(s):  
Ömer Aktug ◽  
Ralf Herpertz ◽  
Kathrin Brehmer ◽  
Rüdiger Autschbach ◽  
Nikolaus Marx ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
New Left ◽  
Pacemaker Implantation ◽  
Term Outcome ◽  
Bundle Branch Block ◽  
Long Term Outcome ◽  
The Impact

Evaluation of Conduction Disorders after Aortic Valve Replacement with Rapid Deployment Bioprostheses

2018 ◽  
Vol 13 (5) ◽  
pp. 356-360
Author(s):  
Augusto D'Onofrio ◽  
Lorenzo Bagozzi ◽  
Chiara Tessari ◽  
Annalisa Francescato ◽  
Giorgia Cibin ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Pacemaker Implantation ◽  
Bundle Branch Block ◽  
End Point ◽  
Conduction Disorders ◽  
Single Center Study ◽  
Bundle Branch Blocks ◽  
Qrs Duration ◽  
Rapid Deployment ◽  
New Onset

Objective The aim of this retrospective, single-center study was to evaluate the occurrence of conduction disorders after rapid deployment aortic bioprosthesis implantation. Methods Electrocardiograms of patients undergoing INTUITY (Edwards Lifesciences, Irvine, CA USA) bioprosthesis implantation were collected at admission, during postoperative course, and at discharge. Primary end point was the occurrence of new-onset conduction disorders, defined as complete left bundle branch block, complete right bundle branch block, permanent pacemaker implantation, and worsening of pre-existing rhythm abnormalities. Secondary end points were the assessment of preoperative and postoperative QRS duration and the identification of transitory conduction disorders. Results Forty-four patients (July 2015–December 2016) were included in the analysis. Preoperatively, patients with normal conduction and with already existing disorders were 25 (56.8%) and 19 (43.2%), respectively. Primary end point occurred in 14 patients (31.8%). Two patients (4.5%) received pacemaker implantation. In patients with normal preoperative conduction, new abnormalities were found in eight cases (32%): all left bundle branch blocks with one pacemaker implantation. Worsening of pre-existing conduction disorders was found in six patients (31.6%) with one pacemaker implantation. QRS duration increased in 20 patients (45.4%), and average increase was 37 milliseconds. Overall, we observed a significant increase of QRS (96 ± 21 milliseconds vs. 111 ± 28 milliseconds, P < 0.001). Three patients experienced a new-onset temporary left bundle branch block. Conclusions New-onset conduction disorders or worsening of pre-existing rhythm abnormalities occur in one third of patients after rapid deployment aortic bioprosthesis implantation. Although the incidence of postoperative pacemaker implantation before discharge is low, strict follow-up is mandatory to identify a potential need for pacemaker implantation in a timely manner.

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