Valvular & structural heart disease
Incidence and Outcomes of New-Onset Right Bundle Branch Block Following Transcatheter Aortic Valve Replacement
Authors' conclusion
Although infrequent, post-TAVR RBBB was associated with elevated PPM implantation risk.
Study context
- Population
- Patients ≥18 years without preexisting right bundle branch block (RBBB) or permanent pacemaker (PPM) undergoing transcatheter aortic valve replacement (TAVR) at US Mayo Clinic sites, June 2010 to May 2021
- Participants
- 1,992 patients
- Exposure
- New-onset RBBB vs no RBBB after TAVR
- Post-TAVR RBBBn = 15
- Without RBBBn = 1,977reference
- Outcome
- Incidence of post-TAVR RBBB; risks of PPM implantation (within 90 days) and mortality
Methodological detailsmulticentre, propensity score adjustment
- Multicentre
- Propensity score adjustment
Main finding
As reported in the abstract
Incidence of new RBBB post-TAVR
15
0.75%
Observational data: associations, not effects.
Further findings
| Outcome | Post-TAVR RBBB | Without RBBB | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| High-grade AV block with PPM implantation (within 90 days) | 66.7% | 13.6% | 8.36 (4.19–16.7) | P < 0.001 | |
| Time to PPM, median (Q1, Q3) | 1 day (0.2, 4) | Not reported in the abstract | Without RBBB: not reported in the abstract | ||
| MortalityAdjusted for age and sex | 0.83 (0.33–2.11) | P = 0.69 | |||
| 0.050.21520Hazard ratio (log scale) |
Valve oversizing
P = 0.034
- High-grade AV block with PPM implantation (within 90 days): propensity score adjusted (age, sex, balloon-expandable valve, annulus diameter, valve oversizing)
Original publication
Incidence and Outcomes of New-Onset Right Bundle Branch Block Following Transcatheter Aortic Valve Replacement. Circ Arrhythm Electrophysiol. Published 30 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it