Clinical characteristics, incidence, and outcomes of transcatheter aortic valve implantation stratified by new-onset left bundle branch block: A single-center pilot study

Fajer Alabdulrazzaq; Mohammed Al Jarallah; Rajesh Rajan; Raja Dashti; Nader Alasousi; Vladimir Kotevski; Ahmed Said Taha Mousa; Gary Tse; Kobalava D Zhanna; Parul Setiya; Ahmad Al-Saber; Peter A Brady; Joud Al Balool

doi:10.4103/ACCJ.ACCJ_20_21

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Online ISSN : 2666-6987

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ORIGINAL ARTICLE

Year : 2022 \| Volume : 4 \| Issue : 1 \| Page : 9-14

Clinical characteristics, incidence, and outcomes of transcatheter aortic valve implantation stratified by new-onset left bundle branch block: A single-center pilot study Fajer Alabdulrazzaq¹, Mohammed Al Jarallah², Rajesh Rajan³, Raja Dashti², Nader Alasousi², Vladimir Kotevski², Ahmed Said Taha Mousa², Gary Tse⁴, Kobalava D Zhanna⁵, Parul Setiya⁶, Ahmad Al-Saber⁷, Peter A Brady⁸, Joud Al Balool⁹ ¹ Faculty of Medicine, Royal College of Surgeons Ireland, Dublin, Ireland ² Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait ³ Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait; Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named after V.S. Moiseev, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation ⁴ Cardiovascular Analytics Group, Hong Kong, China, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China ⁵ Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named after V.S. Moiseev, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation ⁶ Department of Agrometeorology, College of Agriculture, G.B.Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India ⁷ Department of Mathematics and Statistics, University of Strathclyde, Glasgow, G1 1XH, UK ⁸ Department of Cardiology, Illinois Masonic Medical Center, Chicago, IL, USA ⁹ Faculty of Medicine, Kuwait University, Jabria, Kuwait Correspondence Address: Dr. Rajesh Rajan Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City 15003 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ACCJ.ACCJ_20_21

Background: Clinical outcomes after transcatheter aortic valve implantation (TAVI) patients have not been reported in the Gulf region. Objectives: To define the baseline electrocardiographic (ECG), echocardiographic, and computed tomographic findings of patients undergoing TAVI and analyze the predictors of developing new-onset persistent left bundle branch block (LBBB). Methods: Patients with severe aortic stenosis who underwent TAVI between 2013 and 2021 at the Sabah Al-Ahmed Cardiac Centre in Al-Amiri Hospital in the state of Kuwait were included in this study. Baseline characteristics, electrocardiography (ECG), echocardiography, and preprocedural computed tomography data were extracted. The primary outcome was new-onset LBBB. Results: A total of 61 patients were included (65.6% females; mean age: 73.5 ± 9 years; baseline ejection fraction: 55.5% ± 9.7%). Of these, 18 developed new-onset LBBB. Those who developed LBBB tended to have lower ejection fraction (52.5 ± 9.6 vs. 56.8% ± 9.5%; P = 0.116). Those who developed LBBB were more likely to develop 1^st degree atrioventricular block post-TAVI (P = 0.001). Conclusion: The incidence of new-onset LBBB post-TAVI was 29.5%. The new-onset LBBB group was more likely to develop conduction abnormalities requiring permanent pacemaker implantation.



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