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Changes in atrioventricular conduction and predictors of pacemaker need after percutaneous implantation of the

Antonio J Muñoz-García1, José M Hernández-García, Manuel F Jiménez-Navarro

  • 1Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España. ajmunozgarcia@secardiologia.es

Revista Espanola De Cardiologia
|December 15, 2010
PubMed

Insights

Percutaneous aortic valve replacement with CoreValve® frequently leads to pacemaker need due to atrioventricular block. Deeper prosthesis implantation in the left ventricular outflow tract predicts this complication, aiding early identification.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Transcatheter aortic valve implantation (TAVI) is a common procedure for severe aortic stenosis.
  • Atrioventricular conduction abnormalities are frequent post-TAVI, but predictors remain unclear.

Purpose of the Study:

  • To investigate electrocardiogram (ECG) abnormalities and identify predictors of pacemaker requirement after CoreValve® TAVI.

Main Methods:

  • Retrospective analysis of 65 patients undergoing CoreValve® implantation.
  • Clinical and ECG parameters were collected.
  • Predictors for pacemaker need due to advanced atrioventricular block were analyzed.

Main Results:

  • 34.4% of patients required a permanent pacemaker.
  • Left bundle branch block occurred in 47.5% of cases.
  • Deeper prosthesis implantation depth in the left ventricular outflow tract (LVOT) was the sole predictor (OR 1.9, P< .007).

Conclusions:

  • A significant proportion of patients require pacemakers after CoreValve® implantation.
  • LVOT implantation depth is a reliable early predictor of pacemaker need.
Abstract

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