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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Atrioventricular conduction after transcatheter aortic valve implantation and surgical aortic valve replacement

Laurent Roten1, Stefan Stortecky, Flavio Scarcia

  • 1Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.

Journal of Cardiovascular Electrophysiology
|May 17, 2012
PubMed

Insights

Atrioventricular conduction abnormalities (AVCA) are common after transcatheter aortic valve implantation (TAVI), with many resolving within 24 hours. Persistent AVCA occur more frequently after TAVI than surgical aortic valve replacement (SAVR).

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Atrioventricular conduction abnormalities (AVCA) can complicate transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR).
  • Understanding the incidence and resolution of AVCA post-TAVI and SAVR is crucial for patient management.

Purpose of the Study:

  • To prospectively evaluate the occurrence and characteristics of AVCA following TAVI and SAVR.
  • To compare the incidence and persistence of AVCA between TAVI and SAVR procedures.

Main Methods:

  • Prospective study involving 50 TAVI patients and 25 SAVR patients.
  • Continuous 7-day Holter ECG monitoring post-procedure, alongside pre- and post-procedural 12-lead ECGs.
  • Analysis of baseline characteristics, new AVCA, resolution rates, and complete atrioventricular block.

Main Results:

  • TAVI patients were older with baseline PR interval prolongation and wider QRS duration compared to SAVR patients.
  • New AVCA occurred in 58% of TAVI patients (primarily left bundle branch block) and 12% of SAVR patients.
  • Predilatation induced AVCA in 28% of TAVI patients; 30% of new AVCA resolved within 24 hours, while 28% persisted in TAVI patients versus 12% in SAVR patients.

Conclusions:

  • Nearly half of AVCA during TAVI are induced by predilatation, with half resolving within 24 hours.
  • Persistent AVCA are more common after TAVI compared to SAVR.
  • A QRS width below 120 milliseconds on the first day post-TAVI suggests a low risk of late-onset AVCA.
Abstract

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