Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study
Background. Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. Objective. To de...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi-Wiley
2023-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2023/5390338 |
| _version_ | 1797809203220316160 |
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| author | Claudia See Yanting Wang Haocheng Huang Helen Parise Yiping Yang Daniela Tirziu Dominic P. Francese Nikolaos Papoutsidakis Eric Bader Ryan K. Kaple Michael Cleman Alexandra J. Lansky John K. Forrest |
| author_facet | Claudia See Yanting Wang Haocheng Huang Helen Parise Yiping Yang Daniela Tirziu Dominic P. Francese Nikolaos Papoutsidakis Eric Bader Ryan K. Kaple Michael Cleman Alexandra J. Lansky John K. Forrest |
| author_sort | Claudia See |
| collection | DOAJ |
| description | Background. Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. Objective. To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes. Methods. This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death. Results. Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%, p<0.001) and had a greater unadjusted 1-year cardiac-related and all-cause mortality risk (HR 2.54, p=0.044 and HR 1.90, p=0.046, respectively). Conclusion. Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up. |
| first_indexed | 2024-03-13T06:49:00Z |
| format | Article |
| id | doaj.art-f6935a6d1bda4f908fb84fb9b794c4f6 |
| institution | Directory Open Access Journal |
| issn | 1540-8183 |
| language | English |
| last_indexed | 2024-03-13T06:49:00Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj.art-f6935a6d1bda4f908fb84fb9b794c4f62023-06-08T00:00:03ZengHindawi-WileyJournal of Interventional Cardiology1540-81832023-01-01202310.1155/2023/5390338Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center StudyClaudia See0Yanting Wang1Haocheng Huang2Helen Parise3Yiping Yang4Daniela Tirziu5Dominic P. Francese6Nikolaos Papoutsidakis7Eric Bader8Ryan K. Kaple9Michael Cleman10Alexandra J. Lansky11John K. Forrest12From the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineCardiovascular Medicine Clinical Research Analytics GroupFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineFrom the Section of Cardiovascular MedicineBackground. Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. Objective. To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes. Methods. This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death. Results. Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%, p<0.001) and had a greater unadjusted 1-year cardiac-related and all-cause mortality risk (HR 2.54, p=0.044 and HR 1.90, p=0.046, respectively). Conclusion. Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up.http://dx.doi.org/10.1155/2023/5390338 |
| spellingShingle | Claudia See Yanting Wang Haocheng Huang Helen Parise Yiping Yang Daniela Tirziu Dominic P. Francese Nikolaos Papoutsidakis Eric Bader Ryan K. Kaple Michael Cleman Alexandra J. Lansky John K. Forrest Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study Journal of Interventional Cardiology |
| title | Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study |
| title_full | Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study |
| title_fullStr | Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study |
| title_full_unstemmed | Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study |
| title_short | Impact of New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study |
| title_sort | impact of new onset conduction disturbances following transcatheter aortic valve replacement on outcomes a single center study |
| url | http://dx.doi.org/10.1155/2023/5390338 |
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