Long-Term Atrioventricular Block Following Valve Surgery: Electrocardiographic and Surgical Predictors

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jan 23

PMID 38256672

Authors

Jacopo Farina

Mauro Biffi

Gianluca Folesani

Luca Di Marco

Sofia Martin

Corrado Zenesini

Carlo Savini

Matteo Ziacchi

Igor Diemberger

Cristian Martignani

Davide Pacini

Affiliations

Soon will be listed here.

Abstract

Background: Bradyarrhythmia requiring pacemaker implantation among patients undergoing valve surgery may occur even after several years, with unclear predictors. Our aim was to investigate the incidence of pacemaker implantation at different follow-up times and identify associated predictors.

Methods: We conducted a retrospective study evaluating 1046 consecutive patients who underwent valve surgery at the Cardiac Surgery Division of Bologna University Hospital from 2005 to 2010.

Results: During 10 ± 4 years of follow-up, 11.4% of these patients required pacemaker implantation. Interventions on both atrioventricular valves independently predicted long-term pacemaker implantation (SHR 2.1, 95% CI 1.2-3.8, = 0.014). Preoperative atrioventricular conduction disease strongly predicted long-term atrioventricular block, with right bundle branch block as the major predictor (SHR 7.0, 95% CI 3.9-12.4, < 0.001), followed by left bundle branch block (SHR 4.9, 95% CI 2.4-10.1, < 0.001), and left anterior fascicular block (SHR 3.9, 95% CI 1.8-8.3, < 0.001).

Conclusion: Patients undergoing valvular surgery have a continuing risk of atrioventricular block late after surgery until the 12-month follow-up, which was clearly superior to the rate of atrioventricular block observed at long-term. Pre-operative atrioventricular conduction disease and combined surgery on both atrioventricular valves are strong predictors of atrioventricular block requiring pacemaker implantation.

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