Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study.
Journal
Journal of interventional cardiology
ISSN: 1540-8183
Titre abrégé: J Interv Cardiol
Pays: United States
ID NLM: 8907826
Informations de publication
Date de publication:
2023
2023
Historique:
received:
10
01
2023
revised:
05
04
2023
accepted:
18
04
2023
medline:
12
6
2023
pubmed:
9
6
2023
entrez:
9
6
2023
Statut:
epublish
Résumé
Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes. This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death. Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%, Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up.
Sections du résumé
Background
UNASSIGNED
Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes.
Objective
UNASSIGNED
To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes.
Methods
UNASSIGNED
This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death.
Results
UNASSIGNED
Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%,
Conclusion
UNASSIGNED
Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up.
Identifiants
pubmed: 37292113
doi: 10.1155/2023/5390338
pmc: PMC10247319
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5390338Informations de copyright
Copyright © 2023 Claudia See et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest. Dr. Ryan Kaple is on the speaker bureau for Abbott and Edwards Lifesciences. Dr. John Forrest reported grants and personal fees from Medtronic Inc and Edwards Lifesciences outside the submitted work.
Références
JACC Cardiovasc Interv. 2022 Jan 24;15(2):162-164
pubmed: 35057986
Eur Heart J. 2012 Oct;33(19):2403-18
pubmed: 23026477
Neth Heart J. 2022 Mar;30(3):140-148
pubmed: 33914259
J Invasive Cardiol. 2022 Apr;34(4):E326-E333
pubmed: 35366227
JACC Cardiovasc Interv. 2019 Nov 11;12(21):2119-2129
pubmed: 31629743
Curr Cardiol Rep. 2021 Oct 1;23(11):154
pubmed: 34599425
J Am Coll Cardiol. 2020 Aug 25;76(8):985-991
pubmed: 32819472
JACC Cardiovasc Interv. 2016 Apr 25;9(8):805-813
pubmed: 27017367
JACC Cardiovasc Interv. 2016 Feb 8;9(3):244-254
pubmed: 26847116
N Engl J Med. 2011 Jun 9;364(23):2187-98
pubmed: 21639811
Eur Heart J. 2019 Jul 14;40(27):2218-2227
pubmed: 31505615
Am J Cardiol. 2010 Sep 1;106(5):707-12
pubmed: 20723650
N Engl J Med. 2019 May 2;380(18):1695-1705
pubmed: 30883058
Cardiol Rev. 2022 Jul-Aug 01;30(4):179-187
pubmed: 34132653
JAMA. 2013 Nov 20;310(19):2069-77
pubmed: 24240934
N Engl J Med. 2014 May 8;370(19):1790-8
pubmed: 24678937
J Thorac Dis. 2018 Nov;10(Suppl 30):S3614-S3619
pubmed: 30505543
J Am Coll Cardiol. 2013 Sep 10;62(11):1026-34
pubmed: 23644082
J Am Coll Cardiol. 2019 Aug 27;74(8):1086-1106
pubmed: 31439219
J Am Coll Cardiol. 2021 May 11;77(18):2263-2273
pubmed: 33958122
N Engl J Med. 2017 Apr 6;376(14):1321-1331
pubmed: 28304219
N Engl J Med. 2019 May 2;380(18):1706-1715
pubmed: 30883053
Circ Cardiovasc Interv. 2016 May;9(5):e003635
pubmed: 27169577
J Am Coll Cardiol. 2013 Jan 22;61(3):e6-75
pubmed: 23265327
JACC Cardiovasc Interv. 2019 Jan 14;12(1):52-61
pubmed: 30621978
J Interv Card Electrophysiol. 2016 Nov;47(2):143-151
pubmed: 27236653
J Cardiovasc Transl Res. 2014 Jun;7(4):395-405
pubmed: 24800873