Risk factors and prognosis of new-onset conduction block following transcatheter aortic valve implantation
- VernacularTitle:经导管主动脉瓣植入术后新发传导阻滞的危险因素及预后分析
- Author:
Wenbao LIN
1
;
Ke’er ZHENG
1
;
Haiyu CHEN
2
;
Fuzhen ZHENG
2
;
Guoxing WENG
2
;
Xinjing CHEN
2
Author Information
1. Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, P. R. China
2. Cardiovascular Disease Research Center, Fujian Provincial Hospital, Fuzhou, 350001, P. R. China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve implantation (TAVI);
left bundle branch block;
complete atrioventricular block;
permanent pacemaker implantation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(08):977-985
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze predictive factors, clinical implications and prognosis effects of new-onset conduction block after transcatheter aortic valve implantation (TAVI). Methods The clinical data of 86 patients who underwent TAVI through transfemoral approach from 2019 to 2021 in Fujian Provincial Hospital were retrospectively analyzed, including 59 males and 27 females with an average age of 72.9±8.0 years. The patients were divided into a normal group and a new-onset conduction block group according to whether there was new-onset conduction block after operation, and then the new-onset conduction block group was subdivided into a left bundle branch block (LBBB) group (28 patients) and a complete atrioventricular block (CAVB) group (11 patients). We compared the hemodynamics and TAVI-related complications between the postoperative and early follow-up periods, and used the multivariate logistic regression models to identify risk factors for the new-onset conduction block. Results The median EuroSCORE of all patients were 8 (2) points before the operation. In the postoperative and early follow-up periods, the hemodynamics and TAVI-related complications had no statistical difference between the new-onset conduction block group and the normal group (P>0.05). The incidence of permanent pacemaker implantation (81.8%, 9/11) and mortality due to cardiac causes (18.1%, 2/11) in the CAVB group were significantly higher than those in the normal group and theLBBB group (P<0.05). Female, severe calcification of the aortic valve, too large valve size and deep valve implants were the risk factors for new-onset conduction block after TAVI. Conclusion The incidence of LBBB and CAVB is high after TAVI, however, both of them do not significantly effect the hemodynamics of the patients. Higher incidence of permanent pacemaker implantation is found in the CAVB group which affects the rate of rehospitalization and mortality. Female patients, severe calcification of the aortic valve, too large valve size and deep valve implants are the risk factors for the new-onset conduction block after TAVI.
