Clinical impact of baseline right bundle branch block in patients undergoing transcatheter aortic valve replacement
JACC cardiovasc. interv
; 10(15): 1564-1574, 2017. tab, graf
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1064046
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
This study sought to assess the influence of baseline right bundle branch block (RBBB) on all-cause and cardiovascular mortality as well as sudden cardiac death (SCD) among patients undergoing transcatheter aortic valve replacement (TAVR). Few data exist regarding the late clinical impact of pre-existing RBBB in TAVR recipients. A total of 3,527 patients (mean age 82 8 years, 50.1% men) were evaluated according to the presence of RBBB on baseline electrocardiography. Intraventricular conduction abnormalities were classified according to the American Heart Association, American College of Cardiology Foundation, and Heart Rhythm Society recommendations for standardization and interpretation of the electrocardiogram. TAVR complications and causes of death were defined according to Valve Academic Research Consortium 2 definitions. RBBB was present on baseline electrocardiography in 362 patients (10.3%) and associated with higher 30-day rates of permanent pacemaker implantation (PPI) (40.1% vs. 13.5%; p < 0.001) and death (10.2% vs. 6.9%; p » 0.024). At a mean follow-up of 20 18 months, pre-existing RBBB was independently associated with all-cause mortality (hazard ratio [HR] 1.31; 95% confidence interval [CI] 1.06 to 1.63; p » 0.014) and cardiovascular mortality (HR 1.45; 95% CI 1.11 to 1.89; p » 0.006) but not with SCD (HR 0.71; 95% CI 0.22 to 2.32; p » 0.57). Patients with pre-existing RBBB and without PPI at discharge from the index hospitalization had the highest 2-year risk for cardiovascular death (27.8%; 95% CI 20.9% to 36.1%; log-rank p » 0.007). In a subanalysis of 1,245 patients without PPI at discharge from the index hospitalization and with complete follow-up regarding the need for PPI, pre-existing RBBB was independently associated with the composite of SCD and PPI (HR 2.68; 95% CI 1.16 to 6.17; p » 0.023)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Bloqueio de Ramo
/
Morte Súbita Cardíaca
/
Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Guia de prática clínica
Idioma:
Inglês
Revista:
JACC cardiovasc. interv
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
Assistance Publique-Hôpitaux de Paris/FR
/
Clìnica de Occidente de Cali/CO
/
Hospital Clinico Universitario Virgen de la Victoria/ES
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Hospital Clínico Universitario de Valladolid/ES
/
Hospital Israelita Albert Einstein/BR
/
Hospital Universitari Vall d'Hebron/ES
/
Hospital Universitario Central de Asturias/ES
/
Hospital Universitario Clínico San Carlos/ES
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Hôpital Charles Nicolle/FR
/
Instituto Dante Pazzanese de Cardiologia/BR