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Atrioventricular conduction disturbance characterization in transcatheter aortic valve implantation with the

José M Rubín1, Pablo Avanzas, Raquel del Valle

  • 1Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.

Circulation. Cardiovascular Interventions
|May 5, 2011
PubMed

Insights

CoreValve implantation worsens atrioventricular (AV) conduction in most patients. This complication, often permanent, results from direct damage to the His bundle or AV node during the procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Atrioventricular (AV) block is a frequent complication following CoreValve transcatheter aortic valve implantation (TAVI).
  • Understanding the impact of CoreValve on AV conduction is crucial for patient management.

Purpose of the Study:

  • To analyze the effects of CoreValve implantation on atrioventricular (AV) conduction.
  • To investigate the incidence and nature of conduction disturbances post-TAVI.

Main Methods:

  • Electrophysiological studies were conducted immediately before and after CoreValve implantation in 18 pacemaker-free patients.
  • Continuous data recording using His bundle electrodes during the procedure.
  • Analysis of surface ECG and intracardiac electrograms, including AH and HV intervals.

Main Results:

  • Significant prolongation of QRS width (96 to 150 ms) and PR interval (180 to 210 ms) observed.
  • Leftward shift in QRS axis (30° to -20°) and increased AH (97 to 115 ms) and HV (52 to 60 ms) intervals.
  • Persistent conduction disturbances occurred in 78% of patients; 5 experienced transient blocks.

Conclusions:

  • CoreValve implantation leads to worsening of AV conduction in the majority of patients.
  • Conduction disturbances can be transient or permanent.
  • Damage to the His bundle or AV node is the likely cause of these conduction abnormalities.
Abstract

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