Rhythm and Conduct Disorders Associated With Aortic Stenosis: A North African Study

Abstract

Introduction: The location of the conduction pathways and their intimate anatomical relationship with the aortic valve provide insight into the occurrence of arrhythmias and conduction disorders during aortic stenosis. These disorders have an important prognostic impact. our work proposes to determine and describe the rhythm and conduction disorders encountered in aortic stenosis in a Moroccan population group while recalling the causes and the prognostic and therapeutic impacts of this association. Materials and methods: This is a retrospective study of 148 patients with aortic stenosis hospitalized at the cardiology center of the HMIMV over a period of 24 months during which we analyzed the clinical and electrocardiographic data in order to describe and analyze the rhythm and conduction disorders encountered in this pathology. Statistical analysis was performed with SPSS software, version 18. Results: The mean age of the population was 65 (57, 74) years, the sex ratio was 1.21 with male predominance. Smoking (current or former) reported in 38.5% of patients was the main modifiable cardiovascular risk factor, followed by hypertension in 35.8% of patients. Dyspnea of effort was the most frequent reason for consultation at 81% of which 64% (of these) were at least of the functional class III of the NYHA. Palpitations and lipothymia or syncope accounted for 21% and 16.2% of the series. The aortic stenosis was tight overall with a mean aortic area of 0.8 [O, 6; 1] cm². Aortic stenosis was rarely isolated. In 36% of cases, it was associated with rhythm and conduction disorders. Among these disorders, atrial fibrillation was the most frequent (36.5%), followed by left anterior hemiblock (17%), LBBB (13.5%) and RBBB (9.5%). Finally there was 9.4% of complete atrioventricular block. Conclusion: The occurrence of arrhythmias and conduction disorders during aortic stenosis is frequent and due to multifactorial mechanism. In the literature, their prevalence is variable ......