Valvular & structural heart disease
Incidence and management of atrioventricular conduction disorders in new-onset left bundle branch block after transcatheter aortic valve implantation (TAVI): A prospective multicenter study
Authors' conclusion
New-onset LBBB after TAVI was associated with high rates of high-grade AV conduction disturbances.
Study context
- Population
- TAVI recipients with new-onset left bundle branch block (LBBB) persisting >24 hours, mean age 82.3 ± 5.9 years
- Participants
- 183 recipients
- Exposure
- Electrophysiology study (EPS)-based risk stratification: pacemaker vs implantable loop recorder (ILR)
- Pacemakern = 47
- ILRn = 136reference
- Outcome
- Incidence of high-grade AV conduction disorder
- Follow-up
- 12 months
Methodological detailsopen-label, multicentre, 10 centres
- Open-label
- Multicentre
- 10 centres
Main finding
As reported in the abstract
High-grade AV conduction disorder (all patients)
High-grade atrioventricular (AV) conduction disorder identified in 56 patients
30.6%
Observational data: associations, not effects.
Further findings
High-grade AV conduction disorders by His-ventricle interval
- His-ventricle interval ≥70 ms vs lower: more high-grade AV conduction disorders, 53.2% [25 of 47] vs 22.8% [31 of 136]
- P < 0.001
- His-ventricle interval ≥70 ms independently associated with high-grade conduction disorder (multivariate), subdistribution HR 2.4 (95% CI 1.2-4.8)
- P = 0.010
Symptomatic patients
- Four subjects symptomatic, all in the ILR group
- 4
Safety
- No complications associated with the stratification procedure
Original publication
Incidence and management of atrioventricular conduction disorders in new-onset left bundle branch block after TAVI: A prospective multicenter study. Heart Rhythm. Published 13 January 2023. doi:10.
Summarised from the published abstract; every number is checked against it