Author + information
- S1936879815022426-1e7fef46b07b8d5e3d5f9956a10a833aLennart van Gils1,
- S1936879815022426-1d89a3a268baebf88bf7199a2278dc1fDidier Tchetche2,
- S1936879815022426-100738a07812e7e3a5f538314468a525Nicolas Dumonteil3,
- S1936879815022426-73602ee990b20f7cbba203b45f6c7bedMasieh Abawi4,
- S1936879815022426-d672c0034482d2b5ac97702b4edf39a3Ramón Rodriguez-Olivares4,
- S1936879815022426-70b8c41ed958e06e59105f2f858253e9Joost Daemen1,
- S1936879815022426-c0e0180f79882b37144d4a037c34fb40Pierfrancesco Agostini4,
- S1936879815022426-0367642b2a3eea8d6293c272405c0f2fPieter R. Stella4,
- S1936879815022426-dc383b7d4c9eff2208ca1cab3666d728Peter P.T. De Jaegere1 and
- S1936879815022426-9c6d5e2394963d33c21fe1ca6f5b2a50Nicolas. M. van Mieghem1
Right bundle branch block is an independent predictor of permanent pacemaker implantation after TAVI. This multicenter collaboration sought to further elucidate the risk for permanent pacemaker implantation (PPI) in patients with baseline RBBB and categorize for different transcatheter heart valve designs.
We pooled data on TAVI patients from 4 high-volume centers in Europe and selected those with RBBB at baseline.
Three hundred eleven (311) patients with RBBB at baseline were included in the analysis. Median age was 85 (IQR 80-88) and 64% was male. Median STS-score was 7 (IQR 5-10), Femoral access was performed in 85%, compared to 9% and 6% for transsubclavian and transapical, respectively. Following transcatheter valve design were used: CoreValve in 134 cases, Sapien XT in 126 cases, Sapien 3 in 29 cases, Lotus in 15 cases and DirectFlow in 7 cases. Overall permanent pacemaker implantation rate after TAVI was 41%, 71% with the Lotus valve, 46% with CoreValve, 38% with Sapien XT, 24% with Sapien 3 and 14% with DirectFlow. The indication for permanent pacemaker implantation was high degree atrioventricular block in 97% of the cases. Ventricular paced rhythm was observed in 45% of the patients at 30-day follow-up visit. Thirty-day and 1-year mortality were 6% and 17%, respectively.
RBBB at baseline is associated with a high incidence of permanent pacemaker implantation for all transcatheter heart valve types. Need for new permanent pacemaker seems highest for the Lotus Valve and Corevalve and lowest for the Sapien XT/ Sapien 3 and Direct Flow.