E-5 | Predictive Factors for High-Degree Atrioventricular Block and Conduction Abnormalities Following Transcatheter Aortic Valve Replacement: Insights from a Comprehensive Meta-analysis

TAVR is a valuable therapeutic standard for symptomatic severe aortic stenosis in non-surgical candidates. However, it is associated with complications such as high-degree atrioventricular blocks (HAVB) and conduction abnormalities (CA). While various predictors have been discussed in the literature, a comprehensive meta-analysis is lacking. This study seeks to identify and evaluate the most prevalent predictors of HAVB and CA post-TAVR A systematic literature search identified studies on the predictors of HAVB and CA post-TAVR. Binary random-effects models estimated pooled odds ratios (OR) and 95% confidence intervals (CI). A leave-one out sensitivity analysis was performed. Heterogeneity was assessed using I2 statistics. We analyzed a total of 14 studies involving 3757 patients. The mean age of the population studied was 79.9 years. Cardiovascular risk factors, along with atrial fibrillation, were increasingly reported in the HAVB and CA cohorts among the studies. Results indicated increased odds of post-TAVR HAVB and CA among patients with increased implantation depth (OR: 6.18 [1.16-32.88] p <0.01; I2 89.58%), ΔMSID (difference between membranous septum length and depth of implanted valve) (OR: 1.89 [1.21-2.95] p <0.01; I2 92.5%), and preexisting RBBB (OR: 5.74 [2.08-15.87] p <0.01; I2 88.08%). Preexisting RBBB, implantation depth, and ΔMSID have shown increased odds of HAVB and CA. Identifying these predictors could potentially lower the occurrence of HAVB and CA, leading to improved clinical outcomes.