1. Predictors and prognostic impact of new left bundle branch block after surgical aortic valve replacement.
- Author
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Khounlaboud M, Flécher E, Fournet M, Le Breton H, Donal E, Leclercq C, Mabo P, Leguerrier A, and Daubert C
- Subjects
- Aged, Aged, 80 and over, Aortic Valve physiopathology, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Bundle-Branch Block diagnosis, Bundle-Branch Block mortality, Bundle-Branch Block physiopathology, Disease-Free Survival, Female, France epidemiology, Health Status, Heart Failure epidemiology, Heart Failure physiopathology, Heart Valve Prosthesis Implantation mortality, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Bundle-Branch Block epidemiology, Heart Valve Prosthesis Implantation adverse effects
- Abstract
Background: Left bundle branch block (LBBB) induces mechanical dyssynchrony that may lead to left ventricular systolic dysfunction., Aims: To evaluate the incidence, predictors and clinical impact of new LBBB in patients undergoing surgical aortic valve replacement (SAVR)., Methods: After exclusion of patients with pre-existing LBBB, a previous pacemaker or a paced rhythm at hospital discharge, 547 consecutive patients undergoing SAVR were included. All-cause death, cardiovascular death and the combined outcome of all-cause death or a first heart failure event were assessed at 3months and 1year. Patients with and without new LBBB were compared., Results: New LBBB occurred in 4.6% of patients after SAVR (compared with 16.4% of patients treated by transcatheter aortic valve implantation during the study period). Previous valve surgery and an immediate postoperative paced rhythm were independent predictors of new LBBB. At 1-year follow-up, there were no significant differences in all-cause death, cardiovascular death, or the combined outcome of all-cause death or a first heart failure event between patients with and without new LBBB. However, new LBBB was associated with a trend towards functional deterioration and more heart failure events at 1year., Conclusion: At 1-year follow-up, new LBBB did not have a significant impact on clinical outcome, but was associated with worse functional status and more heart failure events., (Copyright © 2017. Published by Elsevier Masson SAS.)
- Published
- 2017
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