The following is the summary of “Trends and In-Hospital Outcomes of Patients With Baseline Right Bundle Branch Block Who Underwent Transcatheter Aortic Valve Implantation” published in the February 2023 issue of Cardiovascular Disease by Gilchrist, et al.

The purpose of this study was to use a nationally representative sample of patients with preexisting right bundle branch block (RBBB) to examine current in-hospital outcomes and trends following transcatheter aortic valve implantation (TAVI). Patients who underwent an index TAVI operation in a hospital between 2016 and 2019 were identified using the National Inpatient Sample. The primary endpoints were all-cause hospital mortality, heart block, and PPM implantation.

There were a total of 199,895 TAVI-related hospitalizations. 10,495 cases (5.3%) were found to have RBBB. Patients with RBBB had a higher median age (81 vs. 80 years, P<0.001) and a lower proportion of female patients (35% vs. 47.4%, P<0.001). Complete heart block was more common in patients with RBBB (adjusted odds ratio [aOR] 4.77, CI 4.55 to 5.01, P<0.001), as was PPM implantation (adjusted odds ratio [aOR] 4.15, CI 3.95 to 4.35, P<0.001), but there was no difference in the in-hospital mortality rate (adjusted odds ratio [aOR] 0.85, CI 0.69 to There was a decrease in the number of PPMs implanted in hospitalized patients with and without RBBB of 3.5% and 2.9%, respectively, between 2016 and 2019. 

Overall, the percentage of PPMs implanted in-hospital during the index TAVI hospitalization for patients with and without RBBB declined between 2016 and 2019. However, complete heart block necessitating PPM implantation remains uncommon, especially in patients with RBBB at baseline. Therefore, further research and advancements are required to decrease complication rates and the necessity for PPM implantation.

Source: sciencedirect.com/science/article/abs/pii/S0002914922011900