Abstract 136: Impact of Abnormal Ventricular Conduction on TAVR Outcomes

Abstract

Background and hypothesis: The association of abnormal ventricular conduction with co-morbidities and effect of conduction abnormalities on TAVR outcomes have not been well investigated. Methods: A retrospective chart review was conducted in 200 consecutive TAVR patients. ECG data was collected and stratified into normal conduction (WNL, n=138), LBBB (n=25), RBBB (n=20), and intra-ventricular conduction delay (IVCD, n=17). Outcomes were adjudicated according to the PARTNER trial definitions (NEJM 2010; 363: 1597-1607). Analyses of variation, correlation, chi-square, and logistic regression were used. The study was approved by the institutional IRB. Results: There was no association between any conduction delay and history of CVA, PVD, chronic renal disease, smoking, hyperlipidemia, hypertension, or COPD. Conduction delays were associated with decreased ejection fraction (LBBB 45.4+/-2.2, RBBB 50.3+/-1.5, IVCD 48.0+/-3.2 vs. 50.7+/-10.9 in WNL conduction, p= 0.03) and lower aortic valve gradient (LBBB 35.0+/- 3.2 mm Hg, RBBB 42.2+/- 2.9, IVCD 40.5 +/- 5.0 vs. 46.2+/-1.5 in WNL conduction, p= 0.022). Standard error was used as the measure of dispersion. Despite the decreased ejection fraction and lower aortic valve gradient, conduction delays were not associated with an increased incidence of post-TAVR death, re-hospitalizations, stroke, or acute renal failure. Conclusion: Despite association with decreased ejection fraction and lower aortic valve gradient, electrocardiographic conduction delays do not lead to inferior TAVR outcomes.