Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve

M Urena; M Mok; V Serra; E Dumont; L Nombela-Franco; R DeLarochelliere; D Doyle; A Igual; E Larose; I Amat-Santos; M Cote; H Cuellar; P Pibarot; Peter de Jaegere; F Philippon; BG del Blanco; J Rodes-Cabau

doi:10.1016/j.jacc.2012.07.035

Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve

M Urena, M Mok, V Serra, E Dumont, L Nombela-Franco, R DeLarochelliere, D Doyle, A Igual, E Larose, I Amat-Santos, M Cote, H Cuellar, P Pibarot, Peter de Jaegere, F Philippon, BG del Blanco, J Rodes-Cabau

Cardiology

Research output: Contribution to journal › Article › Academic › peer-review

227 Citations (Scopus)

Abstract

Objectives This study evaluated the predictive factors and prognostic value of new-onset persistent left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable valve. Background The predictors of persistent (vs. transient or absent) LBBB after TAVI with a balloon-expandable valve and its clinical consequences are unknown. Methods A total of 202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation (PPI) who underwent TAVI with a balloon-expandable valve were included. Patients were on continuous electrocardiographic (ECG) monitoring during hospitalization and 12-lead ECG was performed daily until hospital discharge. No patient was lost at a median follow-up of 12 (range: 6 to 24) months, and ECG tracing was available in 97% of patients. The criteria Results New-onset LBBB was observed in 61 patients (30.2%) after TAVI, and had resolved in 37.7% and 57.3% at hospital discharge and 6- to 12-month follow-up, respectively. Baseline QRS duration (p = 0.037) and ventricular depth of the prosthesis (p = 0.017) were independent predictors of persistent LBBB. Persistent LBBB at hospital discharge was associated with a decrease in left ventricular ejection fraction (p = 0.001) and poorer functional status (p = 0.034) at 1-year follow-up. Patients wit Conclusions Up to 30% of patients with no prior conduction disturbances developed new LBBB following TAVI with a balloon-expandable valve, although it was transient in more than one third. Longer baseline QRS duration and a more ventricular positioning of the prosthesis were associated with a higher rate of persistent LBBB, which in turn determined higher risks for complete AVB and PPI, but not mortality, at 1-year follow-up. (J Am Coll Cardiol 2012;60:1743-52) (C) 2012 by the American College o

Original language	Undefined/Unknown
Pages (from-to)	1743-1752
Number of pages	10
Journal	Journal of the American College of Cardiology
Volume	60
Issue number	18
DOIs	https://doi.org/10.1016/j.jacc.2012.07.035
Publication status	Published - 2012

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10.1016/j.jacc.2012.07.035

http://hdl.handle.net/1765/63343

Cite this

Urena, M., Mok, M., Serra, V., Dumont, E., Nombela-Franco, L., DeLarochelliere, R., Doyle, D., Igual, A., Larose, E., Amat-Santos, I., Cote, M., Cuellar, H., Pibarot, P., de Jaegere, P., Philippon, F., del Blanco, BG., & Rodes-Cabau, J. (2012). Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve. Journal of the American College of Cardiology, 60(18), 1743-1752. https://doi.org/10.1016/j.jacc.2012.07.035

@article{fd01791585d342d8a6a6d909bedeb0d1,

title = "Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve",

abstract = "Objectives This study evaluated the predictive factors and prognostic value of new-onset persistent left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable valve. Background The predictors of persistent (vs. transient or absent) LBBB after TAVI with a balloon-expandable valve and its clinical consequences are unknown. Methods A total of 202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation (PPI) who underwent TAVI with a balloon-expandable valve were included. Patients were on continuous electrocardiographic (ECG) monitoring during hospitalization and 12-lead ECG was performed daily until hospital discharge. No patient was lost at a median follow-up of 12 (range: 6 to 24) months, and ECG tracing was available in 97% of patients. The criteria Results New-onset LBBB was observed in 61 patients (30.2%) after TAVI, and had resolved in 37.7% and 57.3% at hospital discharge and 6- to 12-month follow-up, respectively. Baseline QRS duration (p = 0.037) and ventricular depth of the prosthesis (p = 0.017) were independent predictors of persistent LBBB. Persistent LBBB at hospital discharge was associated with a decrease in left ventricular ejection fraction (p = 0.001) and poorer functional status (p = 0.034) at 1-year follow-up. Patients wit Conclusions Up to 30% of patients with no prior conduction disturbances developed new LBBB following TAVI with a balloon-expandable valve, although it was transient in more than one third. Longer baseline QRS duration and a more ventricular positioning of the prosthesis were associated with a higher rate of persistent LBBB, which in turn determined higher risks for complete AVB and PPI, but not mortality, at 1-year follow-up. (J Am Coll Cardiol 2012;60:1743-52) (C) 2012 by the American College o",

author = "M Urena and M Mok and V Serra and E Dumont and L Nombela-Franco and R DeLarochelliere and D Doyle and A Igual and E Larose and I Amat-Santos and M Cote and H Cuellar and P Pibarot and {de Jaegere}, Peter and F Philippon and {del Blanco}, BG and J Rodes-Cabau",

year = "2012",

doi = "10.1016/j.jacc.2012.07.035",

language = "Undefined/Unknown",

volume = "60",

pages = "1743--1752",

journal = "Journal of the American College of Cardiology",

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Urena, M, Mok, M, Serra, V, Dumont, E, Nombela-Franco, L, DeLarochelliere, R, Doyle, D, Igual, A, Larose, E, Amat-Santos, I, Cote, M, Cuellar, H, Pibarot, P, de Jaegere, P, Philippon, F, del Blanco, BG & Rodes-Cabau, J 2012, 'Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve', Journal of the American College of Cardiology, vol. 60, no. 18, pp. 1743-1752. https://doi.org/10.1016/j.jacc.2012.07.035

Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve. / Urena, M; Mok, M; Serra, V et al.
In: Journal of the American College of Cardiology, Vol. 60, No. 18, 2012, p. 1743-1752.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve

AU - Urena, M

AU - Mok, M

AU - Serra, V

AU - Dumont, E

AU - Nombela-Franco, L

AU - DeLarochelliere, R

AU - Doyle, D

AU - Igual, A

AU - Larose, E

AU - Amat-Santos, I

AU - Cote, M

AU - Cuellar, H

AU - Pibarot, P

AU - de Jaegere, Peter

AU - Philippon, F

AU - del Blanco, BG

AU - Rodes-Cabau, J

PY - 2012

Y1 - 2012

N2 - Objectives This study evaluated the predictive factors and prognostic value of new-onset persistent left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable valve. Background The predictors of persistent (vs. transient or absent) LBBB after TAVI with a balloon-expandable valve and its clinical consequences are unknown. Methods A total of 202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation (PPI) who underwent TAVI with a balloon-expandable valve were included. Patients were on continuous electrocardiographic (ECG) monitoring during hospitalization and 12-lead ECG was performed daily until hospital discharge. No patient was lost at a median follow-up of 12 (range: 6 to 24) months, and ECG tracing was available in 97% of patients. The criteria Results New-onset LBBB was observed in 61 patients (30.2%) after TAVI, and had resolved in 37.7% and 57.3% at hospital discharge and 6- to 12-month follow-up, respectively. Baseline QRS duration (p = 0.037) and ventricular depth of the prosthesis (p = 0.017) were independent predictors of persistent LBBB. Persistent LBBB at hospital discharge was associated with a decrease in left ventricular ejection fraction (p = 0.001) and poorer functional status (p = 0.034) at 1-year follow-up. Patients wit Conclusions Up to 30% of patients with no prior conduction disturbances developed new LBBB following TAVI with a balloon-expandable valve, although it was transient in more than one third. Longer baseline QRS duration and a more ventricular positioning of the prosthesis were associated with a higher rate of persistent LBBB, which in turn determined higher risks for complete AVB and PPI, but not mortality, at 1-year follow-up. (J Am Coll Cardiol 2012;60:1743-52) (C) 2012 by the American College o

AB - Objectives This study evaluated the predictive factors and prognostic value of new-onset persistent left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable valve. Background The predictors of persistent (vs. transient or absent) LBBB after TAVI with a balloon-expandable valve and its clinical consequences are unknown. Methods A total of 202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation (PPI) who underwent TAVI with a balloon-expandable valve were included. Patients were on continuous electrocardiographic (ECG) monitoring during hospitalization and 12-lead ECG was performed daily until hospital discharge. No patient was lost at a median follow-up of 12 (range: 6 to 24) months, and ECG tracing was available in 97% of patients. The criteria Results New-onset LBBB was observed in 61 patients (30.2%) after TAVI, and had resolved in 37.7% and 57.3% at hospital discharge and 6- to 12-month follow-up, respectively. Baseline QRS duration (p = 0.037) and ventricular depth of the prosthesis (p = 0.017) were independent predictors of persistent LBBB. Persistent LBBB at hospital discharge was associated with a decrease in left ventricular ejection fraction (p = 0.001) and poorer functional status (p = 0.034) at 1-year follow-up. Patients wit Conclusions Up to 30% of patients with no prior conduction disturbances developed new LBBB following TAVI with a balloon-expandable valve, although it was transient in more than one third. Longer baseline QRS duration and a more ventricular positioning of the prosthesis were associated with a higher rate of persistent LBBB, which in turn determined higher risks for complete AVB and PPI, but not mortality, at 1-year follow-up. (J Am Coll Cardiol 2012;60:1743-52) (C) 2012 by the American College o

U2 - 10.1016/j.jacc.2012.07.035

DO - 10.1016/j.jacc.2012.07.035

M3 - Article

C2 - 23040577

SN - 0735-1097

VL - 60

SP - 1743

EP - 1752

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 18

ER -