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Early and persistent intraventricular conduction abnormalities and requirements for pacemaking after percutaneous

Nicolo Piazza1, Yoshinobu Onuma, Emile Jesserun

  • 1Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.

JACC. Cardiovascular Interventions
|May 26, 2009
PubMed

Insights

Percutaneous aortic valve replacement significantly increases left bundle branch block. Patients with pre-existing right bundle branch block may require pacemakers after the procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Previous studies suggest conduction abnormalities after aortic valve replacement.
  • The incidence and pacing needs require further investigation.

Purpose of the Study:

  • To determine the incidence of post-procedural conduction abnormalities.
  • To assess the need for pacing after percutaneous aortic valve implantation.

Main Methods:

  • Retrospective analysis of 40 patients undergoing CoreValve implantation.
  • Electrocardiograms (ECGs) analyzed pre-procedure, post-procedure, and at 1-month follow-up.
  • Documentation of temporary and permanent pacemaker requirements.

Main Results:

  • Significant increase in left bundle branch block (LBBB) from 15% to 55% post-procedure (p=0.001).
  • LBBB incidence decreased to 48% at 1-month follow-up, not statistically significant.
  • 20% required temporary pacing, and 18% required permanent pacing.

Conclusions:

  • Percutaneous aortic valve prosthesis insertion significantly increases LBBB frequency.
  • Pre-existing right bundle branch block indicates a higher risk for complete heart block and pacing dependency.
Abstract

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