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Incidence of Atrioventricular Block After Valve Replacement in Carcinoid Heart Disease

Igor Sunjic1,2, Doosup Shin3,2, Katlynd M Sunjic4

  • 1Division of Cardiovascular Sciences, University of South Florida Morsani College of Medicine, Tampa, FL 33606, USA.

Cardiology Research
|February 26, 2020
PubMed

Insights

Carcinoid heart disease patients undergoing valve surgery have a high risk of atrioventricular block (AVB). Nearly one-third required pacemaker implantation, suggesting prophylactic lead placement may be beneficial.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Oncology

Background:

  • Carcinoid heart disease (CaHD) significantly impacts patient morbidity and mortality.
  • Cardiac valve surgery is the primary treatment for heart failure in CaHD.
  • Atrioventricular block (AVB) is a known complication, but its incidence in CaHD is understudied.

Purpose of the Study:

  • To determine the incidence of AVB after valve surgery in CaHD patients.
  • To evaluate the need for permanent pacemaker (PPM) implantation post-surgery.
  • To inform potential prophylactic strategies.

Main Methods:

  • Retrospective analysis of consecutive CaHD patients undergoing valve surgery (2001-2015).
  • Exclusion of patients with pre-existing permanent pacemakers (PPM).
  • Data collection on baseline characteristics, ECG, and echocardiography.

Main Results:

  • Nineteen patients included; 18 had dual valve replacement.
  • Zero 30-day post-surgical mortality.
  • 31.5% (n=6) required PPM implantation for complete AVB within 6 months.
  • No significant differences in baseline parameters between PPM and non-PPM groups.

Conclusions:

  • Approximately one-third of CaHD patients require PPM after valve replacement due to AVB.
  • Prophylactic epicardial lead placement during surgery may prevent complications.
  • This strategy could reduce risks associated with later pacemaker lead insertion.
Abstract

Keywords:
Atrioventricular blockCarcinoid heart diseasePacemakerValve diseaseValve replacement surgery

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