Valvular & structural heart disease
Permanent pacemaker implantation and left bundle branch block with self-expanding valves - a SCOPE 2 subanalysis
Primary result · PPIResult — go to the resultOdds ratio 0.50 95% CI 0.31–0.81Authors' conclusion
New LBBB and PPI rates were lower in ACURATE neo compared to CoreValve Evolut recipients. The ACURATE neo valve was associated with a lower risk of PPI at 30 days. No effect on 1-year mortality was determined for PPI at 30 days, while LBBB at 30 days was associated with reduced ejection fraction at 1 year.
Study context
- Population
- Patients receiving self-expanding TAVI prostheses in the SCOPE 2 trialno previous pacemaker
- Participants
- 648 patients
- Comparison
- ACURATE neo vs CoreValve Evolut
- Primary endpoint
- Incidence of new LBBB and PPI
- Follow-up
- 30 days
Primary result
PPI
Odds ratio
0.50
95% CI 0.31–0.81
P = 0.005
By group
ACURATE neovs CoreValve Evolut
OR 0.50 (95% CI 0.31–0.81); P = 0.005
As reported in the abstract
- Overall permanent pacemaker implantation (PPI) at 30 days
- 16.5%
Further findings
Persistent new LBBB · 30 days
P = 0.007
Previous right bundle branch block and PPI risk · 30 days
| OR (95% CI) | P value | ||
|---|---|---|---|
| Previous right bundle branch block | 6.11 (3.19–11.73) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
- Persistent new left bundle branch block (LBBB) — Overall persistent LBBB at 30 days
- 9.4%
- Persistent new LBBB: 426 patients without previous LBBB
1-year mortality by new PPI
- Similar in patients with and without new PPI
EF at 1 year, new LBBB vs none
- New LBBB vs no new LBBB: 65.7%±11.0 vs 69.1%±7.6
- P = 0.041
Original publication
Permanent pacemaker implantation and left bundle branch block with self-expanding valves - a SCOPE 2 subanalysis. EuroIntervention. Published 6 February 2023. doi:10.
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