Valvular & structural heart disease
Outcomes in patients with electrocardiographic left ventricular dyssynchrony following transcatheter aortic valve replacement
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 2.16 95% CI 1.07–4.37Authors' conclusion
Among TAVR patients with preserved LVEF and normal AV conduction, development of postprocedural LV dyssynchrony secondary to high-burden RV pacing or permanent LBBB was associated with significantly higher risk of death and cardiomyopathy at 1-year follow-up.
Study context
- Population
- Consecutive transcatheter aortic valve replacement (TAVR) patients with preserved left ventricular ejection fraction (LVEF), University of Michigan, January 2012 to June 2017; excluded pre-existing cardiac implantable electronic device, previous left bundle branch block (LBBB), LVEF <50% or follow-up <1 yearmean age 77 years
- Participants
- 362 patients
- Exposure
- Left ventricular (LV) dyssynchrony vs no LV dyssynchrony after TAVR
- LV dyssynchronyn = 91
- Controln = 271reference
- Outcome
- All-cause mortality
Methodological detailssingle-centre, consecutive patients, adjusted analysis
- Single-centre
- Consecutive patients
- Adjusted analysis
Main finding
As reported in the abstract
Adjusted hazard ratio
2.16
95% CI 1.07–4.37
LV dyssynchrony vs Control
adjusted HR 2.16 (95% CI 1.07–4.37)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | LV dyssynchrony | Control | Adjusted HR (95% CI) |
|---|---|---|---|
| Cardiomyopathy (LVEF ≤45%) | 14.80 (6.31–14.69) | ||
| Change in LVEF · 1-year follow-up | mean decline 10.5% (SD 10.2%) | mean increase 0.5% (SD 7.7%) |
Original publication
Outcomes in patients with electrocardiographic left ventricular dyssynchrony following transcatheter aortic valve replacement. Heart Rhythm. Published 7 August 2022. doi:10.
Summarised from the published abstract; every number is checked against it