Predictive factors for pacemaker requirement after transcatheter aortic valve implantation

BMC Cardiovascular Disorders

Research Article

Stephan Kische¹  Henrik Schneider¹  Ilkay Bozdag-Turan¹  Lylia Paranskaya¹  Christoph A Nienaber¹  Gökmen Turan¹  Jasmin Ortak¹  Ulrich Trautwein¹  Dietmar Bänsch¹  Ibrahim Akin¹  Tim C Rehders¹  Dimitar Divchev¹  Hüseyin Ince¹  Olga Thiele¹  Gunther Kundt² 

[1] Heart Center Rostock, Department of Internal Medicine I, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany;Institute for Biostatistics and Information in Medicine and Ageing Research, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany;

关键词: TAVI;    AV block;    Left bundle branch block;    Pacemaker;    His bundle;   

DOI  :  10.1186/1471-2261-12-87

 received in 2012-07-07, accepted in 2012-09-28,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTranscatheter aortic valve implantation (TAVI) has been established as a treatment option for inoperable patients with symptomatic aortic valve stenosis. However, patients suffer frequently from conduction disturbances after TAVI.MethodsBaseline, procedural as well as surface and intracardiac ECG parameters were evaluated for patients treated with TAVI and a comparison between patients requiring pacemaker with those not suffering from relevant conduction disorders were done.ResultsTAVI was successfully in all patients (n=45). Baseline surface and intracardiac ECG recording revealed longer PQ (197.1±51.2 msec versus 154.1±32.1 msec; p<0.001), longer AH (153.6±43.4 msec versus 116.1±31.2 msec; p<0.001) and HV interval (81.7±17.8 msec versus 56.8±8.5 msec; p<0.001) in patients with need for a pacemaker (n=23) versus control group (n=22); furthermore, 7-day follow-up analysis showed a higher prevalence of new left bundle branch block (LBBB) (87.0% versus 31.9%; p<0.001). Multivariate analysis revealed that only new LBBB, QRS duration >120 msec and a PQ interval >200 msec immediately (within 60 minutes) after implantation of the aortic valve were predictors for high-grade (type II second-degree and third-degree) AV block. Other clinical parameters as well as baseline electrocardiographic parameters had no impact on critical conduction delay.ConclusionCardiac conduction disturbances are common after TAVI. The need for pacing after TAVI is predictable by surface ECG evaluation immediately (within 60 minutes) after the procedure.

【 授权许可】

CC BY   
© Akin et al.; licensee BioMed Central Ltd. 2012