One-year follow-up of conduction disturbances following transcatheter aortic valve implantation. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Salizzoni, Stefano; Anselmino, Matteo; Fornengo, Cristina; Giordana, Francesca; La Torre, Michele; Moretti, Claudio; D'Amico, Maurizio; Omedé, Pierluigi; Marra, Sebastiano; Rinaldi, Mauro; Gaita, Fiorenzo
• Is Part Of: Journal of cardiovascular medicine. Volume 16:Issue 4(2015:Apr.)
• Publication Date: 2015-04
• Subjects: Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000179
• Languages: English
• ISSNs: 1558-2027

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Aims</title> <p>To describe the postprocedural and 1-year follow-up incidence of heart conduction disturbances in patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI).</p> </sec> <sec> <title>Methods</title> <p>Ninety-five patients were enrolled from 2008 to 2011 (mean age 81.8 ± 7.2 years, 63.1% women). Clinical and ECG data were recorded at admission, discharge, and 3, 6 and 12 months following TAVI.</p> </sec> <sec> <title>Results</title> <p>Fifty-seven Edwards SAPIEN (31 transapical, 26 transfemoral) and 38 transfemoral CoreValve implants were used. Two (2.1%) patients died during the procedure and 11 (11.6%) patients received a pacemaker prior to discharge (7 CoreValve, 3 transapical, 1 transfemoral SAPIEN; <italic>P</italic> = 0.18). Among the surviving patients not receiving a pacemaker, TAVI increased the PQ interval (176 ± 29 vs. 188 ± 36 ms; <italic>P</italic> = 0.001), QRS width (90 ± 15 vs. 108 ± 26 ms; <italic>P</italic> < 0.001), and first-grade atrioventricular block (17 vs. 29%; <italic>P</italic> < 0.001). Postprocedural complete left bundle branch block was reported most in transapical (from 10 to 36%; <italic>P</italic> = 0.01) and CoreValve (from 8 to 64%; <italic>P</italic> < 0.001) recipients compared to the transfemoral SAPIEN group. At the 12-month follow-up, 24 (25.3%) patients had died [two (2.1%) sudden deaths] and four (4.2%) required pacemaker implantation. Among the survivors not receiving a pacemaker at the 1-year follow-up, the PQ interval (178 ± 27 vs. 188 ± 36 ms; <italic>P</italic> = 0.39) remained unchanged in the ECG, whereas the QRS width (100 ± 22 vs. 108 ± 26 ms; <italic>P</italic> = 0.008) decreased compared to measurements taken at discharge.</p> </sec> <sec> <title>Conclusion</title> <p>Conduction disturbances following TAVI primarily develop during hospitalization and subsequently stabilize. However, the small percentage of patients suffering sudden death or pacemaker implantation requires attention.</p> </sec> </abstract>