B-PO05-157 ASSOCIATION OF INCREASING QRS DURATION WITH NEW-ONSET LEFT VENTRICULAR SYSTOLIC DYSFUNCTION FOLLOWING TRANSCATHETER AORTIC VALVE REPLACEMENT

Abstract

Left ventricular systolic dysfunction (LVSD) is an independent risk factor of adverse clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, there is limited data regarding the incidence, predictors and significance of new-onset LVSD (nLVSD) following TAVR. To estimate the prevalence of nLVSD among patients after TAVR and identify associated risk factors. In this retrospective study, 181 patients underwent TAVR in a single center between 12/7/2016 and 9/14/2020. Demographics, comorbidities, 12-lead electrocardiogram (EKG) at baseline and post TAVR were collected. Echocardiographic assessment of LV ejection fraction (LVEF) was recorded at baseline, 30 days and 1 year. Of 181 patients, 10 patients (5.5%, 95% confidence interval [CI]: 3, 10) developed nLVSD. Mean LVEF (%) decreased significantly between patients with and with no nLVSD at 30 days (39.0 ± 13.0 vs. 57.2 ± 8.8, p < 0.01) and 1 year (31.0 ± 7.4 vs. 59.3 ± 6.8, p < 0.01) (Tab 1). Among patients with nLVSD, 5 (50%) patients exhibited systolic deterioration within 30 days. Of those nLVSD, QRS duration significantly increased after TAVR compared to QRS at baseline (HR 4.0; 95% CI, 1.1-14.3, p < 0.05) (Fig 1). New conduction defects were found in patients with nLVSD including 3 new-onset left bundle branch block (BBB), 1 right BBB and 2 patients who underwent new permanent pacemaker. The incidence of nLVSD was 5.5% after TAVR, and increased QRS duration post TAVR is associated with nLVSD. Larger studies are needed to confirm these findings as well as identify predictors of nLVSD post TAVR and further clinical outcomes.