Left ventricular outflow morphology as a predictor of arrhythmic disturbances after TAVI

Abstract Introduction Left bundle branch block (LBBB) and permanent pacemaker (PM) are frequent complications after transcatheter aortic valve implantation (TAVI), but few predictors have been reported. Purpose This study sought to determine the relationship between left ventricular outflow tract (LVOT) morphology development of conduction disturbances TAVI. Methods From 1/2020 12/2020 consecutive patients who underwent TAVI an analyzable CT scan in our center were selected. Patients categorized according LVOT into three groups. The delta value mean root diameter (AA-d) LVOT-d calculated, divided terciles. In third tercile AA-d was greater than defined as tapered-LVOT (group 1). First second terciles had tubular or flared-LVOT shape group 2. We compared conductance disorders with without tapered-LVOT. Primary endpoint combined new-onset transient/persistent LBBB, PM. Factors p<0.05 on univariate analysis entered multivariate analysis. Results Among 98 eligible thirty-two (33%) presented a (Group 1) 66 (67%) 2). age 80.5±5.5 years 60% female. Baseline characteristics similar groups except for incidence dyslipidemia that higher primary significantly 1 (78% vs. 59%: p=0.036). After adjusting confounding factors, this remained statistically significant (OR: 2.81 (CI95%: 1–7.96), p 0.046). Independent disturbance were: tapered-LVOT, prior coronary artery disease surgical replacement. Conclusions TAVI, presenting 2.8-fold risk develop LBBB require PM when another shapes. FUNDunding Acknowledgement Type funding sources: None.