SPC365

Early Discharge Safety in TAVI Patients with New-Onset Left Bundle Branch Block

Session: SESSÃO DE POSTERS 05 - TAVI 1
Speaker: Rita Louro

Congress: CPC 2025
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.3 Non-coronary Cardiac Intervention
Session Type: Cartazes
FP Number: ---
Authors: Rita Louro; António Almeida; Orlando Luquengo; Rafael Viana; Marta Figueiredo; Miguel Carias; Conceição Patinho; David Neves; Ângela Bento; Renato Fernandes; Gustavo Sá Mendes; Lino Patrício

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>BACKGROUND: </strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Light&quot;,sans-serif">Transcatheter Aortic Valve Implantation (TAVI) is now the first-line therapeutic approach for a growing number of patients. However, conduction system disturbances and the need for a permanent pacemaker (PPM) are well-known complications. Among these, new onset left bundle branch block (LBBB) is recognised as a harmfull sign of complications during follow-up in this subgroup of patients, raising concerns among clinicians, the reason leading to delay in discharge.</span></span></span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>METHODS: </strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Light&quot;,sans-serif">Retrospective analysis of data consecutive collected prospectively, assessed TAVI patients, from a single centre, focusing on conduction complications and pacemaker implantation. </span><span style="font-family:&quot;Aptos Light&quot;,sans-serif">Patients who died during hospitalization, those with a pre-existing PPM, and those who required a PPM during hospitalization were excluded. The aim was to compare patients with </span><span style="font-family:&quot;Aptos Light&quot;,sans-serif">new-onset LBBB with a control group (absence of new-onset LBBB).</span> <span style="font-family:&quot;Aptos Light&quot;,sans-serif">The primary outcome was the incidence of readmission leading to PPM at 1 month and 6 months follow-up (FUP) and the secondary outcome was length of hospital stay. &nbsp;</span></span></span></span></p>

<p style="text-align:start">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>RESULTS: </strong></span></span></span></p>

<p style="text-align:justify"><span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">From a total of 300 patients undergoing TAVI, 33 patients had new-onset LBBB and 190 remaining were attributed the control group.</span><span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">&nbsp;At 1-month FUP, 1 (3.0%) patient with </span><span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">new-onset LBBB patients </span><span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">had readmission leading to PPM, comparing with 3 (1.1%) in the control group, which was not significant (p value 0.383). At 6 months FUP, was also not significant (p-value 0.159), with a total of 2 (6.1%) patients with </span><span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">new-onset LBBB</span> <span style="color:#000000; font-family:&quot;Aptos Light&quot;,sans-serif; font-size:medium">needing PPM, and 3 (1.6%) in the control group. Patients with new-onset LBBB had a median&nbsp;stay of 3.00 (IQR 3) days and the control group of 3.00 (IQR 4), without significance (p-value 0.546</span><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Light&quot;,sans-serif">). </span></span></span></span></p>

<p style="text-align:start">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>CONCLUSIONS</strong><span style="font-family:&quot;Aptos Light&quot;,sans-serif">: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Light&quot;,sans-serif">The results of cohort results demonstrate that patient discharge was conducted safely and without delay, as the length of hospital stay was not significantly prolonged in patients with new-onset LBBB and a similar rate of readmission leading to PPM compared to the rest of the population. In summary, these findings support the feasibility of implementing early discharge protocols for TAVI patients with new-onset LBBB.</span></span></span></span></p>