Comparison of Incidence and Predictors of Left Bundle Branch Block After Transcatheter Aortic Valve Implantation Using the CoreValve Versus the Edwards Valve

Franzoni, Irene; Latib, Azeem; Maisano, Francesco; Costopoulos, Charis; Testa, Luca; Figini, Filippo; Giannini, Francesco; Basavarajaiah, Sandeep; Mussardo, Marco; Slavich, Massimo; Taramasso, Maurizio; Cioni, Micaela; Longoni, Matteo; Ferrarello, Santo; Radinovic, Andrea; Sala, Simone; Ajello, Silvia; Sticchi, Alessandro; Giglio, Manuela; Agricola, Eustachio; Chieffo, Alaide; Montorfano, Matteo; Alfieri, Ottavio; Colombo, Antonio

doi:10.1016/j.amjcard.2013.04.026

Cited by 119 publications

(63 citation statements)

References 25 publications

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“…Five studies (5612 patients) were excluded from the quantitative synthesis because of missing data on the primary end point, despite reporting different outcomes based on the presence of new-onset LBBB or the need of PPI post-TAVR. [13][14][15][16][17] Finally, 17 studies were included for assessing primary end points, and of those, 8 studies were deemed eligible for assessing the outcome of patients with new-onset LBBB post-TAVR, 5,6,[18][19][20][21][22][23][24] whereas 11 studies were deemed eligible for assessing the outcome of patients with PPI post-TAVR. 5,7,8,[17][18][19][25][26][27][28][29][30][31] Figure 1 shows the PRISMA flow diagram.…”

Section: Resultsmentioning

confidence: 99%

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Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

Regueiro

Altisent

Trigo

et al. 2016

Circ: Cardiovascular Interventions

245

138

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Background-Available data on the clinical impact of new-onset left bundle branch block (LBBB) and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) remains controversial. We aimed to evaluate the impact of (1) periprocedural new-onset LBBB or PPI post-TAVR on cardiac mortality and all-cause 1-year mortality and (2) new-onset LBBB on the need for PPI at 1-year follow-up. Methods and Results-We performed a systematic search from PubMed and EMBASE databases for studies reporting raw data on new-onset LBBB post-TAVR and the need for PPI or mortality at 1-year follow-up, or on 1-year mortality according to the need for periprocedural PPI post-TAVR. Data from 17 studies, including 4756 patients (8 studies) and 7032 patients (11 studies) for the evaluation of the impact of new-onset LBBB and periprocedural PPI post-TAVR were sourced, respectively (with 2 studies used for both outcomes). New-onset LBBB post-TAVR was associated with a higher risk of PPI (risk ratio [RR], 2.18; 95% confidence interval [CI], 1.28-3.70) and cardiac death (RR, 1.39; 95% CI, 1.04-1.86) during follow-up, as well with a tendency toward an increase in all-cause mortality (RR, 1.21; 95% CI, 0.98-1.50). Periprocedural PPI post-TAVR was not associated with any increased risk of all-cause mortality at 1 year (RR, 1.03; 95% CI, 0.9-1.18), yet a tendency toward a protective effect on cardiac death was observed (RR, 0.78; 95% CI, 0.60-1.03). Conclusions-New-onset LBBB post-TAVR is a marker of an increased risk of cardiac death and need for PPI at 1-year follow-up. The need for PPI early post-TAVR did not increase the risk of death. (Circ Cardiovasc Interv. 2016;9:e003635.

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Section: Resultsmentioning

confidence: 99%

“…The risk of 1-year all-cause death was evaluated from 8 studies 6,[18][19][20][21][22][23]32 that included 4756 patients (SEV 36.5% versus BEV 63.5%). The overall pooled RR was 1.21 (95% CI, 0.98-1.50; P=0.07; Figure 2C).…”

Section: Impact Of New-onset Lbbb After Tavr On the Risk Of Death Andmentioning

confidence: 99%

Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

Regueiro

Altisent

Trigo

et al. 2016

Circ: Cardiovascular Interventions

245

138

View full text Add to dashboard Cite

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“…The diagnosis criteria for LBBB were based on the recommendations from the American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society 20 in 4 studies 3,4,13,18 and from the World Health Organizational/International Society and Federation for Cardiology 21 in 2 studies. 11,19 One study 12 did not detail the diagnosis criteria. The study-selection process is shown in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

Ando

Takagi

2016

Clinical Cardiology

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New-onset persistent left bundle branch block (NOP-LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP-LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP-LBBB patients after TAVI were included. The random-effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals. Adjusted HRs were utilized over unadjusted HRs or risk ratios when available. A total of 4049 patients (807 and 3242 patients with and without NOP-LBBB, respectively) were included. Perioperative (in-hospital or 30-day) and midterm all-cause mortality and midterm cardiovascular mortality were comparable between the groups. The NOP-LBBB patients experienced a higher rate of permanent pacemaker implantation (HR: 2.09, 95% confidence interval: 1.12-3.90, P = 0.021, I 2 = 83%) during midterm follow-up. We found that NOP-LBBB after TAVI resulted in higher permanent pacemaker implantation but did not negatively affect the midterm prognosis. Therefore, careful observation during the follow-up is required.

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“…68,72,73 Several studies attempted to identify predictors of pacemaker implantation following TAVR and demonstrated that an older age, the use of the Medtronic CoreValve revalving system (ie, the incidence of pacemaker implantation in the CoreValve US Pivotal extreme risk iliofemoral study was 22%, whereas in the PARTNER Cohort B trial, in which the Edwards transcatheter heart valve [Edwards Lifesciences Inc, Irvine, CA] was implanted, it was only 3.4%), the presence of right bundle branch block, a low placement of the prosthesis, a porcelain aorta, and valve oversizing are associated with conduction disorders that required pacemaker implantation. 5,33,[74][75][76][77][78][79][80] The prognostic implications of this complication is under question as 3 studies showed no association between conduction abnormalities and prognosis and only one demonstrated increased mortality in patients who developed left bundle branch block during TAVR. [81][82][83][84] On the contrary, there is robust evidence that conduction disorders have a negative effect on LV systolic function and on patient's functional status.…”

Section: Conduction Disordersmentioning

confidence: 99%

Evolution of Transcatheter Aortic Valve Replacement

Bourantas

Serruys

2014

Circulation Research

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Comparison of Incidence and Predictors of Left Bundle Branch Block After Transcatheter Aortic Valve Implantation Using the CoreValve Versus the Edwards Valve

Cited by 119 publications

References 25 publications

Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

Evolution of Transcatheter Aortic Valve Replacement

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