Conduction Disorders Associated with Rapid Deployment AVR

Objectives: Postoperative left bundle branch block (LBBB) and permanent pacemaker (PPM) implantations are frequent complications after the implantation of rapid deployment valves. We analyzed permanent pacemaker implantation rates after rapid deployment aortic valve replacement and identified associated factors.

Methods: A total of 490 patients were analyzed who underwent rapid deployment AVR between March 2012 and September 2017. Isolated aortic valve replacement was performed in 287 cases and AVR with concomitant bypass surgery in 203 cases. The findings of preoperative electrocardiograms were compared with postoperative electrocardiogram findings. New-onset LBBB and postoperative pacemaker rates were recorded.

Results: The incidence of new onset LBBB was 18.9% and the postoperative pacemaker implantation rate after 30 days 6.4%. Independent predictors of permanent pacemaker implantation were baseline right bundle branch block (odds ratio: 5.37, p < 0.0001), larger valve size (1.46, p = 0.013), and atrioventricular block (1.65, p = 0.042).

Conclusion: Rapid deployment AVR is associated with a considerable rate of new-onset LBBB and PPM which remains a matter of concern. Patient factors associated with PPI after rapid deployment aortic valve replacement were right bundle branch block, atrioventricular block, and larger valve size.

No conflict of interest has been declared by the author(s).