Effective Distance between Aortic Valve and Conduction System Is an Independent Predictor of Persistent Left Bundle Branch Block during Transcatheter Aortic Valve Implantation

Thomas T. Poels*, Robert Stassen, Suzanne Kats, Leo Veenstra, Vincent van Ommen, Bastiaan Kietselaer, Patrick Houthuizen, Jos G. Maessen, Frits W. Prinzen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Background and objectives: Persistent left bundle branch block (P-LBBB) has been associated with poor clinical outcomes of transcatheter aortic valve implantation (TAVI) procedures. We hypothesized that the distance from the aortic valve to the proximal conduction system, expressed as the effective distance between the aortic valve and conduction system (EDACS), can predict the occurrence of P-LBBB in patients undergoing a TAVI procedure. Materials and methods: In a retrospective study, data from 269 patients were analyzed. EDACS was determined using two longitudinal CT sections. Results: Sixty-four of the patients developed P-LBBB. EDACS ranged between -3 and +18 mm. EDACS was significantly smaller in P-LBBB than in non-P-LBBB patients (4.6 (2.2-7.1) vs. 8.0 (5.8-10.2) mm, median values (interquartile range); p < 0.05). Receiver operating characteristic analysis showed an area under the curve of 0.78 for predicting P-LBBB based on EDACS. In patients with EDACS of 10 mm, the chance of developing P-LBBB was >= 50% and 25. As EDACS can be measured pre-procedurally, it may be a valuable additional factor to weigh the risks of transcatheter and surgical aortic valve replacement.

Original languageEnglish
Article number476
Number of pages13
JournalMedicina-Lithuania
Volume57
Issue number5
DOIs
Publication statusPublished - May 2021

Keywords

  • transcatheter aortic valve implantation
  • left bundle branch block
  • predictor
  • computed tomography scan
  • PERMANENT PACEMAKER IMPLANTATION
  • LATE CLINICAL-OUTCOMES
  • ATRIOVENTRICULAR-BLOCK
  • REPLACEMENT
  • IMPACT
  • RISK
  • ABNORMALITIES
  • STENOSIS

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