Key result
Patients with symptomatic aortic valvular disease have a high incidence of atrioventricular and intraventricular conduction abnormalities, affecting 78.9% with regurgitation and 61.5% with stenosis.
Why the study?
What is the incidence and nature of atrioventricular and intraventricular conduction disturbances in patients with symptomatic aortic valvular disease?
Observational (n=32)
What is the incidence and nature of atrioventricular and intraventricular conduction disturbances in patients with symptomatic aortic valvular disease?
Absolute Event Rate: 78.9% vs 61.5%
Symptomatic aortic valvular disease, particularly aortic regurgitation, is associated with a high incidence of atrioventricular and intraventricular conduction abnormalities.
High prevalence of conduction abnormalities in aortic valve disease; leaves open role of routine His-bundle studies.
Electrophysiologic studies of His' bundle were done on 32 consecutive patients with symptomatic aortic valvular disease. Nineteen had pure aortic regurgitation and 13 had aortic stenosis, four with significant regurgitation. Fifteen of the former had atrioventricular (AV) and/or intraventricular (IV) conduction abnormalities. In those with aortic stenosis, eight had conduction abnormalities, all intraventricular but one. Twelve of the 13 with aortic stenosis had radiographically indentifiable valve calcification; all four with a peak systolic gradient greater than 80 mm Hg had IV conduction defects. Of the 32 patients, six had A-H prolongation and in all the predominant lesion was aortic regurgitation (one with moderate stenosis). There was no difference in age, clinical congestive heart failure, coronary artery disease, or prolonged H-V interval. However, PR prolongation (P = .01) and decreased ejection fraction (P = .02) was significantly increased in the former group. Patients with aortic regurgitation had longer A-H and H-V intervals (NS), induced A-V block at lower heart rates (P = .01), and higher A-V node effective (P = .001) and functional (P = .01) refractory periods. In summary, patients with aortic valvular disease have a high incidence of atrioventricular and intraventricular conduction disease.
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MAUTNER et al. (1980) conducted an observational in Symptomatic aortic valvular disease (n=32). Aortic regurgitation vs. Aortic stenosis was evaluated on Atrioventricular (AV) and/or intraventricular (IV) conduction abnormalities. Patients with symptomatic aortic valvular disease have a high incidence of atrioventricular and intraventricular conduction abnormalities, affecting 78.9% with regurgitation and 61.5% with stenosis.
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