New-onset persistent left bundle branch block following sutureless aortic valve replacement
Por:
Vilalta, V, Cediel, G, Mohammadi, S, Lopez, H, Kalavrouziotis, D, Resta, H, Dumont, E, Voisine, P, Philippon, F, Escabia, C, Borrellas, A, Alperi, A, Fernandez-Nofrerias, E, Carrillo, X, Panagides, V, Bayes-Genis, A and Rodes-Cabau, J
Publicada:
1 ene 2023
Ahead of Print:
1 jul 2022
Resumen:
Objective To evaluate the incidence, predictive factors and prognostic value of new-onset persistent left bundle branch block (NOP-LBBB) in patients undergoing sutureless surgical aortic valve replacement (SU-SAVR). Methods A total of 329 consecutive patients without baseline conduction disturbances or previous permanent pacemaker implantation (PPI) who underwent SU-SAVR with the Perceval valve (LivaNova Group, Saluggia, Italy) in two centres from 2013 to 2019 were included. Patients were on continuous ECG monitoring during hospitalisation and 12-lead ECG was performed after the procedure and at hospital discharge. NOP-LBBB was defined as a new postprocedural LBBB that persisted at hospital discharge. Baseline, procedural and follow-up clinical and echocardiography data were collected in a dedicated database. Results New-onset LBBB was observed in 115 (34.9%) patients, and in 76 (23.1%) persisted at hospital discharge. There were no differences in baseline and procedural characteristics between patients with (n=76) and without (n=253) NOP-LBBB. After a median follow-up of 3.3 years (2.3-4.4 years), patients with NOP-LBBB had a higher incidence of PPI (14.5% vs 6.3%, p=0.016), but exhibited similar rates of all-cause mortality (19.4% vs 19.2%, p=0.428), cardiac mortality (8.1% vs 9.4%, p=0.805) and heart failure readmission (21.0% vs 23.2%, p=0.648), compared with the no/transient LBBB group. NOP-LBBB was associated with a decrease in left ventricular ejection fraction (LVEF) at 1-year follow-up (delta: -5.7 vs +0.2, p<0.001). Conclusions NOP-LBBB occurred in approximately a quarter of patients without prior conduction disturbances who underwent SU-SAVR and was associated with a threefold increased risk of PPI along with a negative impact on LVEF at follow-up.
Filiaciones:
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Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
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Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Mohammadi, S:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
Lopez, H:
Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Kalavrouziotis, D:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
Resta, H:
Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Dumont, E:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
Voisine, P:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
Philippon, F:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
Escabia, C:
Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Borrellas, A:
Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Alperi, A:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
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Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
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Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Panagides, V:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
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Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Rodes-Cabau, J:
Quebec Heart & Lung Inst, Dept Cardiol & Cardiac Surg, Quebec City, PQ, Canada
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