Author + information
- Patrick Houthuizen,
- Robert van der Boon,
- Marina Urena,
- Thomas T. Poels,
- Leen AFM van Garsse,
- Josep Rodés–Cabau,
- Frits W. Prinzen and
- Peter de Jaegere
Transcatheter aortic valve implantation (TAVI) is frequently complicated by new left bundle branch block (LBBB) which may affect long–term outcome. Data on persistence of LBBB after discharge is limited.
Observational cohort study of 429 patients who underwent TAVI from 2006 until July 2011 in 4 centers (Netherlands: Rotterdam, Eindhoven, Maastricht; Canada: Quebec City). Patients with pre–existing LBBB/pacemaker or postprocedural pacemaker were excluded. We reviewed electrocardiograms (ECG) at baseline, post procedure, at discharge and follow–up (6 to 12 months).
There were 39 patients (9%) without follow–up ECG, therefore we analysed 390 patients. A periprocedural LBBB occurred in 39% (n=152) and persisted at a median ECG follow–up of 366 (IQR, 315–393) days in 27% (n=104). Implantation of the Medtronic CoreValve (MCV) was complicated by LBBB in 58% (n=112) and persisted in 43% (n=83) at follow–up compared to 20% (n=40) and 11% (n=21), respectively for the Edwards SAPIEN valve (ESV) (P<0.001). To evaluate the effect of experience (e.g. improved implantation), patients before and after June 2010 were also compared (see table).
A new LBBB is a frequent adverse event of TAVI and recovers in one third of patients. With the MCV, it occurs more often and shows less recovery during follow–up compared to the ESV. With increasing experience, the incidence of LBBB drops after MCV implantation, albeit that permanent LBBB still occurs 3–4 times more frequent.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Structural Heart Disease Intervention
Abstract Category: 49. TCT@ACC–i2: Aortic Valve Disease
Presentation Number: 2114M–228
- 2013 American College of Cardiology Foundation