Author + information
- Yusuke Watanabe1,
- Ken Kozuma1,
- Hirofumi Hioki1,
- Hideyuki Kawashima1,
- Yugo Nara1,
- Makoto Nakashima1,
- Fukuko Nagura1,
- Akihisa Kataoka1,
- Shirai Shinichi2,
- Norio Tada3,
- Motoharu Araki4,
- Kensuke Takagi5,
- Futoshi Yamanaka6,
- Masanori Yamamoto7 and
- Kentaro Hayashida8
- 1Teikyo University School of Medicine, Tokyo, Japan
- 2Kokura Memorial Hospital, Kitakyushu, Japan
- 3Sendai Kousei Hospital, Sendai, Japan
- 4Saiseikai Eastern Hospital, Kanagawa-ken, Japan
- 5Ogaki Citizen Hospital, Gifu, Japan
- 6Shonan Kamakura General Hospital, Kamakura, Japan
- 7Toyohashi Heart Center, Toyohashi, Japan
- 8Keio Univetsity School of Medicine, Tokyo, Japa
The impact of pre-existing right bundle branch block (RBBB) on clinical outcomes after transcatheter aortic valve implantation (TAVI) is unknown.
Between October 2013 and August 2015, 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California, USA) were prospectively enrolled in the OCEAN-TAVI registry from eight Japanese centers. Electrocardiograms were obtained at baseline. After the procedure, follow-up outpatient visits or telephone interviews were conducted at 30 days, 6 months, and then yearly.
A total of 102 (13.6%) patients had a pre-existing RBBB. At baseline, there was no difference between the RBBB group and the no RBBB group except for the prevalence of cerebrovascular disease (21.6% vs. 13.0%, p = 0.02). The incidence of new pacemaker implantation was significantly higher in the RBBB group (17.6% vs. 2.9%, p < 0.01). The Kaplan-Meier analysis revealed that both the over-all and cardiovascular survival probability were significantly lower in the RBBB group than the no RBBB group (log-rank p < 0.01, respectively). The multivariate Cox regression model indicated that pre-existing RBBB (HR: 2.54; 95% confidence interval [CI]: 1.45 to 4.46; p < 0.01) was an independent predictor of all-cause mortality.
Pre-existing RBBB was observed in 13.6% of patients undergoing TAVI, and was significantly related to the incidence of new pacemaker implantation and the increased risk of over-all and cardiovascular mortality after TAVI with a balloon expandable valve.
STRUCTURAL: Valvular Disease: Aortic