TY - JOUR
T1 - In-hospital outcomes of TAVR patients with a bundle branch block
T2 - Insights from the National Inpatient Sample 2011–2018
AU - Zahid, Salman
AU - Khan, Muhammad Z.
AU - Ullah, Waqas
AU - Tanveer Ud Din, Mian
AU - Abbas, Sakina
AU - Ubaid, Aamer
AU - Khan, Muhammad U.
AU - Rai, Devesh
AU - Baibhav, Bipul
AU - Rao, Mohan
AU - Singla, Atul
AU - Goldsweig, Andrew M.
AU - Depta, Jeremiah P.
AU - Balla, Sudarshan
N1 - Funding Information:
No funds are required for this project.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Introduction: Data on the outcomes following transcatheter aortic valve replacement (TAVR) in patients with a bundle branch block (BBB) remains limited. Methods: We studied the outcomes of TAVR patients with a BBB from the National Inpatient Sample (NIS) database between 2011 and 2018 using ICD-9-CM and ICD-10-CM codes. Results: Between 2011 and 2018, 194,237 patients underwent TAVR, where 1.7% (n = 3,232) had a right BBB (RBBB) and 13.7% (n = 26,689) had a left BBB (LBBB). Patients with a RBBB and LBBB had a higher rate of new permanent pacemaker (PPM) implantation (31.5% - RBBB, 15.7% LBBB vs. 10.2% - no BBB). RBBB was associated with a significantly longer median length of stay (5 days) and total hospitalization cost ($53,669) compared with LBBB (3 days and $47,552) and no BBB (3 days and $47,171). Trend analysis revealed lower rates of PPM implantation and reduced lengths of stay and costs across all comparison groups. Conclusion: In conclusion, patients undergoing TAVR with a BBB are associated with higher new rates of PPM implantation. RBBB is the strongest independent predictor for new PPM implantation following TAVR. Rates of new PPM implantation in TAVR patients with and without a BBB have improved over time including reductions in length of stay and hospital costs. Further study is needed to reduce the risks of PPM implantation in TAVR patients.
AB - Introduction: Data on the outcomes following transcatheter aortic valve replacement (TAVR) in patients with a bundle branch block (BBB) remains limited. Methods: We studied the outcomes of TAVR patients with a BBB from the National Inpatient Sample (NIS) database between 2011 and 2018 using ICD-9-CM and ICD-10-CM codes. Results: Between 2011 and 2018, 194,237 patients underwent TAVR, where 1.7% (n = 3,232) had a right BBB (RBBB) and 13.7% (n = 26,689) had a left BBB (LBBB). Patients with a RBBB and LBBB had a higher rate of new permanent pacemaker (PPM) implantation (31.5% - RBBB, 15.7% LBBB vs. 10.2% - no BBB). RBBB was associated with a significantly longer median length of stay (5 days) and total hospitalization cost ($53,669) compared with LBBB (3 days and $47,552) and no BBB (3 days and $47,171). Trend analysis revealed lower rates of PPM implantation and reduced lengths of stay and costs across all comparison groups. Conclusion: In conclusion, patients undergoing TAVR with a BBB are associated with higher new rates of PPM implantation. RBBB is the strongest independent predictor for new PPM implantation following TAVR. Rates of new PPM implantation in TAVR patients with and without a BBB have improved over time including reductions in length of stay and hospital costs. Further study is needed to reduce the risks of PPM implantation in TAVR patients.
KW - Bundle Branch Blocks
KW - TAVI
KW - TAVR
KW - transcatheter aortic valve implantation
KW - transcatheter aortic valve replacement
UR - http://www.scopus.com/inward/record.url?scp=85134189898&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85134189898&partnerID=8YFLogxK
U2 - 10.1002/ccd.30341
DO - 10.1002/ccd.30341
M3 - Article
C2 - 35842779
AN - SCOPUS:85134189898
VL - 100
SP - 424
EP - 436
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 3
ER -