Left Bundle-Branch Block Induced by Transcatheter Aortic Valve Implantation Increases Risk of Death

Patrick Houthuizen, Leen A. F. M. Van Garsse, Thomas T. Poels, Peter de Jaegere, Robert M. A. van der Boon, Ben M. Swinkels, Jurrien M. ten Berg, Frank van der Kley, Martin J. Schalij, Jan, Jr. Baan, Ricardo Cocchieri, Guus R. G. Brueren, Albert H. M. van Straten, Peter den Heijer, Mohamed Bentala, Vincent van Ommen, Jolanda Kluin, Pieter R. Stella, Martin H. Prins, Jos G. MaessenFrits W. Prinzen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

192 Citations (Web of Science)

Abstract

Background-Transcatheter aortic valve implantation (TAVI) is a novel therapy for treatment of severe aortic stenosis. Although 30% to 50% of patients develop new left bundle-branch block (LBBB), its effect on clinical outcome is unclear. Methods and Results-Data were collected in a multicenter registry encompassing TAVI patients from 2005 until 2010. The all-cause mortality rate at follow-up was compared between patients who did not develop new LBBB. Of 679 patients analyzed, 387 (57.0%) underwent TAVI wih the Medtronic CoreValve System and 292 (43.0%) with the Edwards SAPIEN valve. A total of 233 patients (34.3%) developed new LBBB. Median follow-up was 449.5 (interquartiel range, 174-834) days in patients with and 450 (interquartile range, 253-725) days in patients without LBBB (P=0.90). All cause mortality was 37.8% (n=88) in patients with LBBB and 24.0% (n=107) patients without LBBB (P=0.002). By multivariate regression analysis, indepedent predictors of all-cause mortality were TAVI-induced LBBB (hazard ratio [HR], 1.54; condifence interval [CI], 1.12-2.10), chronic obstructive lung disease (HR, 1.56; CI, 1.15-2.10), female sex (HR, 1.39; CI, 1.04-1.85), left ventricular ejection fraction
Original languageEnglish
Pages (from-to)720-728
JournalCirculation
Volume126
Issue number6
DOIs
Publication statusPublished - 7 Aug 2012

Keywords

  • conduction
  • heart failure
  • left bundle-branch block
  • mortality
  • transcatheter aortic valve implantation

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