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Clinical Impact of Preexisting Right Bundle Branch Block after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Joint Authors
Saint Croix, Garly R.
Lacy, Spencer C.
Hrachian, Hakop
Beohar, Nirat
Source
Journal of Interventional Cardiology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-07-22
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Introduction.
Transcatheter aortic valve replacement (TAVR) is now the treatment of choice for patients with severe aortic stenosis regardless of their surgical risk.
Right bundle branch block (RBBB) can be a predictor for development of significant atrioventricular (AV) block after TAVR, requiring permanent pacemaker implantation (PPI).
However, data related to the risk of PPI requirement with preexisting RBBB is scarce.
Hence, this systematic review and meta-analysis aims to assess clinical outcomes of patients undergoing TAVR with RBBB on preexisting electrocardiogram.
Methods.
We performed a systematic literature review to identify randomized and nonrandomized clinical studies that reported any clinical impact of patients undergoing TAVR with preexisting RBBB.
A total of eight databases including PubMed (Medline), Embase, Cochrane Library, ACP Journal Club, Scopus, DARE, and Ovid containing articles from January 2000 to May 2020 were analyzed.
Results.
We identified and screened 224 potential eligible publications through the databases and found 14 relevant clinical trials for a total of 15,319 participants.
There was an increased 30-day pacemaker implantation rate of 38.1% in the RBBB group compared to 11.4% in the no RBBB group with a risk ratio of 3.56 (RR 3.56 (95% CI 3.21–3.93, p<0.01)).
There was an increased 30-day all-cause mortality in the RBBB group of 9.5% compared with 6.3% in the no RBBB group with an odds ratio of 1.60 (OR 1.60 (95% CI 1.14–2.25, p<0.01)).
Conclusion.
This study indicates that patients with preexisting RBBB have higher incidence of PPI and all-cause mortality after TAVR compared with patients without RBBB.
Further trials are needed to compare the clinical outcomes based on TAVR valve types and assess the benefit of PPI in patients with new-onset RBBB after TAVR.
American Psychological Association (APA)
Saint Croix, Garly R.& Lacy, Spencer C.& Hrachian, Hakop& Beohar, Nirat. 2020. Clinical Impact of Preexisting Right Bundle Branch Block after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology،Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1187755
Modern Language Association (MLA)
Saint Croix, Garly R.…[et al.]. Clinical Impact of Preexisting Right Bundle Branch Block after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology No. 2020 (2020), pp.1-8.
https://search.emarefa.net/detail/BIM-1187755
American Medical Association (AMA)
Saint Croix, Garly R.& Lacy, Spencer C.& Hrachian, Hakop& Beohar, Nirat. Clinical Impact of Preexisting Right Bundle Branch Block after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Journal of Interventional Cardiology. 2020. Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1187755
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1187755