# LDL-C: An Important Independent Risk Factor for New-Onset Heart Block in Patients with Severe Aortic Stenosis and Heart Failure after TAVR

## TL;DR

High LDL-C levels and changes in the QRS interval are significant risk factors for heart block after TAVR in patients with aortic stenosis.

## Contribution

Identifies LDL-C and △QRS interval as novel independent risk factors for new-onset heart block after TAVR.

## Key findings

- 34.4% of TAVR patients developed heart block.
- High preoperative LDL-C and △QRS interval were significant independent risk factors.
- Other factors like atrial fibrillation and △QT interval were associated but not independent.

## Abstract

Transcatheter aortic valve replacement (TAVR) is an
effective alternative treatment for patients with aortic stenosis (AS) who have
intermediate to high surgical risk or who are inoperable. However, the incidence
of conduction abnormalities is high after TAVR, which can reduce the
effectiveness of the surgery. Our research objective is to explore the risk
factors of new-onset conduction abnormalities after TAVR, providing reference
value for clinical doctors to better prevent and treat conduction abnormalities.

Patients who underwent TAVR were divided into those who
developed heart block and those who did not. Baseline clinical characteristics,
cardiac structural parameters, procedural characteristics, electrocardiogram (ECG) changes before and
after TAVR (△ = postoperative minus preoperative), and surgical
complications were compared. Logistic regression was applied to identify
significant risk factors for new-onset heart block.

We studied
93 patients, of whom 34.4% developed heart blocks. Univariate logistic
regression showed that prior history of malignancy, atrial fibrillation,
preoperative high-level total cholesterol and low-density lipoprotein cholesterol
(LDL-C), △HR, △QRS interval,
△QT interval, and △QTc interval were risk
factors of new-onset heart block after TAVR. Multivariate analysis showed that
preoperative high-level LDL-C and △QRS interval remained
significant independent risk factors after adjusting for potential confounds.

Heart block is the most common complication of TAVR, and
its significant independent risk factors include high-level LDL-C and
△QRS interval.