Conduction Disorders after Rapid Deployment Aortic Valve Replacement Compared to Conventional Aortic Valve Replacement

Background: We evaluated and compared early postprocedural as well as midterm incidence and evolution of atrioventricular and intraventricular conduction disorders following rapid deployment aortic valve replacement and conventional aortic valve replacement.

Method: A total of 147 patients who underwent isolated rapid deployment AVR between 2017 and 2021 as well as 128 patients after conventional biological AVR in the same period were included in this study. ECGs recorded at baseline, discharge, and 12 months were retrospectively analyzed. Intrinsic rhythm, PR interval, QRS duration, and atrioventricular and intraventricular conduction were evaluated and compared between both groups.

Results: Patients in both groups had a comparable STS score (2.9 ± 1.6 vs. 3.1 ± 2.2; p = 0.32) and comparable baseline characteristics. The mean age was 72.4 ± 5.7 years in the RDAVR group and 73.2 ± 5.9 years in the AVR group, respectively.

Patients in the RDAVR group more frequently had QRS prolongation (71 vs. 11%, p < 0.001).

The incidence of left bundle branch block was increased in the RDAVR group after 12 months (19.3% vs. 5.1%; p < 0.001). The mean QRS width in the RDAVR groups was 117.2 ± 30.3 and 100.5 ± 23.1 ms in the AVR group at 12 months. Permanent pacemaker implantation rates were significantly higher in the RDAVR group after 12 months. (12.9% vs. 6.3%, p < 0.001) Mortality did not differ in both groups after 12 months (8.1% vs. 7.1%, p = 0.32).

Conclusion: Patients after RDAVR showed significant higher rates of left bundle branch block and permanent pacemaker implantation after 12 months. However, higher mortality was not observed in the RDAVR group.

Publication History

Article published online:
28 January 2023