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Predictors and prognostic impact of new left bundle branch block after surgical aortic valve replacement.
- Source :
-
Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2017 Dec; Vol. 110 (12), pp. 667-675. Date of Electronic Publication: 2017 Sep 28. - Publication Year :
- 2017
-
Abstract
- Background: Left bundle branch block (LBBB) induces mechanical dyssynchrony that may lead to left ventricular systolic dysfunction.<br />Aims: To evaluate the incidence, predictors and clinical impact of new LBBB in patients undergoing surgical aortic valve replacement (SAVR).<br />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.<br />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.<br />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.<br /> (Copyright © 2017. Published by Elsevier Masson SAS.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1875-2128
- Volume :
- 110
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Archives of cardiovascular diseases
- Publication Type :
- Academic Journal
- Accession number :
- 28964778
- Full Text :
- https://doi.org/10.1016/j.acvd.2017.03.007