Prognosis of new-onset left bundle branch block after transcatheter aortic valve replacement in patients with aortic stenosis: A systematic review and meta-analysis
- VernacularTitle:主动脉瓣狭窄患者经导管主动脉瓣置换术后新发左束支传导阻滞预后的系统评价与Meta分析
- Author:
Jialu WANG
1
;
Shidong LIU
2
;
Xiangxiang HAN
1
;
Xiang LEI
1
;
Tao FANG
1
;
Shuai DONG
2
;
Bing SONG
2
Author Information
1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000. P. R. China
2. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000. P. R. China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve replacement;
left bundle branch block;
prognosis;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(05):624-633
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the clinical outcome of patients with new-onset left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR). Methods Electronic search was performed in PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang and CBM databases to identify studies about the new-onset LBBB after TAVR from inception to March 19, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software. Results A total of 17 cohort studies were included, covering 9 205 patients, including 2 202 patients with new-onset LBBB and 7 003 without new-onset LBBB after TAVR. The results of meta-analysis showed that patients with new-onset LBBB after TAVR at 30-day (RR=1.65, 95%CI 1.30 to 2.10, P<0.001) and 1-year (RR=1.30, 95%CI 1.16 to 1.45, P<0.001) all-cause mortality was higher than no new-onset LBBB group. One-year cardiovascular mortality was higher in the new-onset LBBB group (RR=1.47, 95%CI 1.21 to 1.79, P<0.001). In the occurrence of 30-day (RR=1.51, 95%CI 1.10 to 2.08, P=0.011) and 1-year (RR=1.34, 95%CI 1.14 to 1.58, P=0.001) rehospitalization rate, 30-day (RR=3.05, 95% CI 1.49 to 6.22, P=0.002) and 1-year (RR=2.15, 95%CI 1.52 to 3.03, P<0.001) pacemaker implantation, the incidence of patients with new-onset LBBB was higher than that of the no new-onset LBBB group. Conclusion Compared with the patients without LBBB after TAVR, the clinical prognosis of patients with new-onset LBBB after TAVR is poor. In the future, the management and follow-up of the patients with LBBB after TAVR should be further strengthened to improve the prognosis of patients.
