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

Jacopo Farina1, Mauro Biffi2, Gianluca Folesani3

  • 1Cardiology Unit, Arcispedale Sant'Anna, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Ferrara, Italy.

Journal of Clinical Medicine
|January 23, 2024
PubMed

Insights

Patients undergoing valve surgery face a continuing risk of bradyarrhythmia requiring pacemaker implantation. Pre-operative conduction disease and combined valve interventions are key predictors for this long-term complication.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Bradyarrhythmia requiring pacemaker implantation can occur years after valve surgery.
  • Predictors for late pacemaker implantation after valve surgery are not well understood.

Purpose of the Study:

  • To investigate the incidence of pacemaker implantation at various follow-up times post-valve surgery.
  • To identify predictors associated with pacemaker implantation in this patient cohort.

Main Methods:

  • Retrospective study of 1046 patients undergoing valve surgery.
  • Data collected from 2005 to 2010 at Bologna University Hospital.

Main Results:

  • 11.4% of patients required pacemaker implantation during a 10 ± 4 year follow-up.
  • Interventions on both atrioventricular valves predicted long-term pacemaker implantation (SHR 2.1).
  • Preoperative atrioventricular conduction disease, including right bundle branch block (SHR 7.0), strongly predicted atrioventricular block.

Conclusions:

  • A continuing risk of atrioventricular block requiring pacemaker implantation exists up to 12 months post-valve surgery.
  • Pre-operative atrioventricular conduction disease and combined atrioventricular valve surgery are significant predictors of pacemaker implantation.
Abstract

Keywords:
cardiac valve surgerylong-term follow-uppacemaker implantation

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