TY - JOUR
T1 - Late Electrocardiographic Changes in Patients With New-Onset Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation
AU - Faroux, Laurent
AU - Muntané-Carol, Guillem
AU - Urena, Marina
AU - Nombela-Franco, Luis
AU - Amat-Santos, Ignacio
AU - Kleiman, Neal
AU - Munoz-Garcia, Antonio
AU - Atienza, Felipe
AU - Serra, Vicenç
AU - Deyell, Marc W.
AU - Veiga-Fernandez, Gabriela
AU - Masson, Jean Bernard
AU - Canadas-Godoy, Victoria
AU - Himbert, Dominique
AU - Fischer, Quentin
AU - Castrodeza, Javier
AU - Elizaga, Jaime
AU - Pascual, Jaume Francisco
AU - Webb, John G.
AU - de la Torre, Jose M.
AU - Asmarats, Lluis
AU - Pelletier-Beaumont, Emilie
AU - Alméndarez, Marcel
AU - Couture, Thomas
AU - Philippon, Francois
AU - Rodes-Cabau, Josep
N1 - Funding Information:
Dr. Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions. Drs. Guillem Muntané-Carol and Lluis Asmarats were supported by a grant from the Fundacion Alfonso Martin Escudero (Madrid, Spain).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - This study sought to determine, in patients with new-onset persistent left bundle branch block (NOP-LBBB) after transcatheter aortic valve implantation (TAVI), the incidence and factors associated with (i) LBBB recovery and (ii) permanent pacemaker implantation (PPI) at 1-year follow-up. This was a multicenter study including 153 patients (mean age: 81 ± 5 years, 56% of women) with NOP-LBBB post-TAVI (balloon-expandable valve in 112 patients). Delta PR (ΔPR) and delta QRS (ΔQRS) were defined as the difference in PR and QRS length between baseline and hospital discharge ECG, and the relative ΔPR and ΔQRS as absolute ΔPR and ΔQRS divided by baseline PR and QRS length, respectively. The patients had a clinical visit and 12-lead ECG at 1-year follow-up. LBBB recovery was observed in 50 patients (33%), and 14 patients (9%) had advanced conduction disturbances requiring PPI during the follow-up period. No clinical or ECG variables were associated with LBBB recovery, including prosthesis type (self- or balloon-expandable valve, p = 0.563), QRS width at baseline/discharge or absolute/relative ΔQRS (p >0.10 for all). The presence of atrial fibrillation at baseline (0.026), a longer PR interval at discharge (0.009), and a longer absolute and relative ΔPR (p = 0.002 and p = 0.004, respectively) were associated with an increased risk of PPI at 1-year follow-up. In conclusion, NOP-LBBB post-TAVI resolved in one-third of patients at 1-year follow-up, but no clinical or ECG variables were associated with LBBB recovery. Conversely, a nonsinus rhythm at baseline and a longer ΔPR were associated with an increased risk of PPI within the year after TAVI.
AB - This study sought to determine, in patients with new-onset persistent left bundle branch block (NOP-LBBB) after transcatheter aortic valve implantation (TAVI), the incidence and factors associated with (i) LBBB recovery and (ii) permanent pacemaker implantation (PPI) at 1-year follow-up. This was a multicenter study including 153 patients (mean age: 81 ± 5 years, 56% of women) with NOP-LBBB post-TAVI (balloon-expandable valve in 112 patients). Delta PR (ΔPR) and delta QRS (ΔQRS) were defined as the difference in PR and QRS length between baseline and hospital discharge ECG, and the relative ΔPR and ΔQRS as absolute ΔPR and ΔQRS divided by baseline PR and QRS length, respectively. The patients had a clinical visit and 12-lead ECG at 1-year follow-up. LBBB recovery was observed in 50 patients (33%), and 14 patients (9%) had advanced conduction disturbances requiring PPI during the follow-up period. No clinical or ECG variables were associated with LBBB recovery, including prosthesis type (self- or balloon-expandable valve, p = 0.563), QRS width at baseline/discharge or absolute/relative ΔQRS (p >0.10 for all). The presence of atrial fibrillation at baseline (0.026), a longer PR interval at discharge (0.009), and a longer absolute and relative ΔPR (p = 0.002 and p = 0.004, respectively) were associated with an increased risk of PPI at 1-year follow-up. In conclusion, NOP-LBBB post-TAVI resolved in one-third of patients at 1-year follow-up, but no clinical or ECG variables were associated with LBBB recovery. Conversely, a nonsinus rhythm at baseline and a longer ΔPR were associated with an increased risk of PPI within the year after TAVI.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve/surgery
KW - Atrial Fibrillation/epidemiology
KW - Bundle-Branch Block/epidemiology
KW - Cardiac Pacing, Artificial
KW - Comorbidity
KW - Electrocardiography
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Pacemaker, Artificial
KW - Postoperative Complications/epidemiology
KW - Recovery of Function
KW - Transcatheter Aortic Valve Replacement
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UR - http://www.scopus.com/inward/citedby.url?scp=85077171957&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2019.11.025
DO - 10.1016/j.amjcard.2019.11.025
M3 - Article
C2 - 31889524
AN - SCOPUS:85077171957
SN - 0002-9149
VL - 125
SP - 795
EP - 802
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 5
ER -