Atrioventricular Conduction Changes After CoreValve Transcatheter Aortic Valve Implantation

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Conduction disturbances are a known complication of transcatheter aortic valve implantation (TAVI).
• CoreValve TAVI is a common treatment for severe aortic stenosis.

Purpose of the Study:

• To analyze cardiac conduction changes following CoreValve TAVI.
• To identify predictors of permanent pacemaker implantation after CoreValve TAVI.

Main Methods:

• 181 patients with severe aortic stenosis undergoing CoreValve TAVI were studied.
• Intracardiac electrocardiograms were performed before and after implantation in 137 patients.
• Predictors for pacemaker implantation within 72 hours were analyzed.

Main Results:

• PR and QRS intervals significantly increased post-implantation (P < .01).
• 49% of patients developed new-onset left bundle-branch block; 25% required a pacemaker within 72 hours.
• Baseline right bundle-branch block and prosthetic depth were independent predictors of pacemaker need.

Conclusions:

• CoreValve TAVI leads to a high incidence of conduction disturbances, particularly left bundle-branch block.
• 25% of patients required a permanent pacemaker post-procedure.
• Pacemaker requirement is associated with baseline right bundle-branch block and prosthetic depth.