TY - JOUR

T1 - Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation

AU - Bjerre Thygesen, Julie

AU - Loh, Poay Huan

AU - Cholteesupachai, Jiranut

AU - Franzen, Olaf

AU - Søndergård, Lars

PY - 2014/2

Y1 - 2014/2

N2 - AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period.METHODS AND RESULTS: A total of 258 consecutive patients underwent TAVI with the Medtronic CoreValve (MCV), whereas 24 patients were excluded from the study. TAVI-related PPM was defined as PPM implantation ≤30 days after the procedure and due to atrioventricular block (AVB). Third-degree AVB, second-degree type-II, or advanced second-degree AVB were considered as absolute indications for PPM. The incidence of TAVI-related PPM implantation was 27.4%. Forty-six patients (19.7%) had an absolute indication for PPM, but CA had resolved in 50% beyond the periprocedural period. Electrocardiographic analysis of the patients who did not have a TAVI-related PPM implantation showed that the PR and QRS intervals increased following TAVI, reaching a peak on days 4-6 and 7-9, respectively, before decreasing to near baseline levels.CONCLUSION: Although the incidence of periprocedural PPM implantation following TAVI was high, most CAs following TAVI tend to resolve after the periprocedural period. This suggests that delaying the decision for PPM implantation after TAVI may reduce the PPM rate.

AB - AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period.METHODS AND RESULTS: A total of 258 consecutive patients underwent TAVI with the Medtronic CoreValve (MCV), whereas 24 patients were excluded from the study. TAVI-related PPM was defined as PPM implantation ≤30 days after the procedure and due to atrioventricular block (AVB). Third-degree AVB, second-degree type-II, or advanced second-degree AVB were considered as absolute indications for PPM. The incidence of TAVI-related PPM implantation was 27.4%. Forty-six patients (19.7%) had an absolute indication for PPM, but CA had resolved in 50% beyond the periprocedural period. Electrocardiographic analysis of the patients who did not have a TAVI-related PPM implantation showed that the PR and QRS intervals increased following TAVI, reaching a peak on days 4-6 and 7-9, respectively, before decreasing to near baseline levels.CONCLUSION: Although the incidence of periprocedural PPM implantation following TAVI was high, most CAs following TAVI tend to resolve after the periprocedural period. This suggests that delaying the decision for PPM implantation after TAVI may reduce the PPM rate.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve

KW - Atrioventricular Block

KW - Cardiac Catheterization

KW - Denmark

KW - Electrocardiography

KW - Female

KW - Follow-Up Studies

KW - Heart Conduction System

KW - Heart Valve Prosthesis Implantation

KW - Humans

KW - Incidence

KW - Male

KW - Pacemaker, Artificial

KW - Retrospective Studies

KW - Severity of Illness Index

M3 - Journal article

C2 - 24486670

VL - 26

SP - 94

EP - 99

JO - Journal of Invasive Cardiology

JF - Journal of Invasive Cardiology

SN - 1042-3931

IS - 2

ER -