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Baseline ECG and Prognosis After Transcatheter Aortic Valve Implantation: The Role of Interatrial Block

2020; Wiley; Volume: 9; Issue: 22 Linguagem: Inglês

10.1161/jaha.120.017624

2047-9980

Lourdes Vicent, Clara Fernández‐Cordón, Luis Nombela‐Franco, Luis Alberto Escobar‐Robledo, Ana Ayesta, Albert Ariza‐Solé, Juan José Gómez‐Doblas, Eva Bernal, Gabriela Tirado‐Conte, Javier Cobiella, Hugo González‐Saldívar, Diego López‐Otero, Pablo Díez‐Villanueva, Fernando Sarnago, Xavier Armario, Antoni Bayés de Luna, Manuel Martínez‐Sellés, Edgar Fadeuilhe, Antonio Serra, Dabit Arzamendi, Xavier Millán, Felipe Díez‐Delhoyo, Lilian Grigorian, Míriam Juárez, M Eugenia Vázquez, Ricardo Sanz, Enrique Gutiérrez, Jaime Elı́zaga, Francisco Fernández‐Avilés, Teresa Alvarado Casas, Fernándo Alfonso, Agustín Albarrán González de Trevilla, Julio García Tejada, Ivan Tomas Gómez Blázquez, Fernando Sarnago, Carme Guerrero Morales, Pablo Avanzas, Yván R. Persia-Paulino, César Morı́s, Javier Cobiella, Xoan Carlos Sanmartín Pena, Javier López País, Antonio Muñoz, Erika Muñoz, J. M. Hernández,

Cardiac Arrhythmias and Treatments

Background The clinical significance of conduction disturbances after transcatheter aortic valve implantation has been described; however, little is known about the influence of baseline ECGs in the prognosis of these patients. Our aim was to study the influence of baseline ECG parameters, including interatrial block (IAB), in the prognosis of patients treated with transcatheter aortic valve implantation. Methods and Results The BIT (Baseline Interatrial Block and Transcatheter Aortic Valve Implantation) registry included 2527 patients with aortic stenosis treated with transcatheter aortic valve implantation. A centralized analysis of baseline ECGs was performed. Patients were divided into 4 groups: normal P wave duration (<120 ms); partial IAB (P wave duration ≥120 ms, positive in the inferior leads); advanced IAB (P wave duration ≥120 ms, biphasic [+/-] morphology in the inferior leads); and nonsinus rhythm (atrial fibrillation/flutter and paced rhythm). The mean age of patients was 82.6±9.8 years and 1397 (55.3%) were women. A total of 960 patients (38.0%) had a normal P wave, 582 (23.0%) had partial IAB, 300 (11.9%) had advanced IAB, and 685 (27.1%) presented with nonsinus rhythm. Mean follow-up duration was 465±171 days. Advanced IAB was the only independent predictor of all-cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.10-1.98 [