Conduction disorders after rapid deployment AVR compared to conventional AVR.

Abstract

Objectives We evaluated and compared incidence and evolution of atrioventricular and intraventricular conduction disorders following rapid deployment AVR and conventional AVR. Methods 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. Results Patients in both groups had comparable a STS score (2.9 ± 1.6 vs 3.1 ± 2.2 p=0.32) and comparable baseline characteristics. At discharge the mean QRS width in the RDAVR group was significantly increased with 117.4  28.6 ms and a mean  QRS width of 21.7  26.3 ms (p<0.001) compared to baseline. No significant changes of QRS width were found in the AVR group with a mean value of 101.2  24.1 ms and a mean  QRS width of 3.9  23.9 ms at discharge (p=0.193). Left bundle branch block was increased in the RDAVR group after 12 months (19.3% vs 5.1% p<0.001) Permanent pacemaker implantation rates were significantly higher in the RDAVR group after 12months. (HR: 4.68; 95% CI: 2.23 - 7.43 p<0.001) Mortality did not differ in both groups after 12 months (HR: 1.09; 95% CI: 0.46 - 1.83; p = 0.835) Conclusions Patients after RDAVR showed significant higher rates of left bundle branch block with significantly increased QRS width and permanent pacemaker implantation after 12 months. However, higher mortality was not observed in the RDAVR group.