Conduction Abnormalities after Transcatheter Aortic Valve Implantation and Diastolic Dysfunction

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Echocardiography

Background:

• Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
• Conduction abnormalities, such as prolonged PR interval and wide QRS complex, frequently occur post-TAVI.
• The impact of these conduction abnormalities on diastolic function remains incompletely understood.

Purpose of the Study:

• To investigate the effect of post-TAVI conduction abnormalities on diastolic function.
• To correlate specific conduction abnormalities (prolonged PR interval, wide QRS) with diastolic parameters.
• To assess the influence of these abnormalities on clinical outcomes, including mortality.

Main Methods:

• 101 patients undergoing TAVI were evaluated with echocardiography at 1 and 6 months post-procedure.
• Diastolic parameters including E/A ratio, E wave deceleration time, E/e' ratio, left atrial (LA) volume, and systolic pulmonary artery pressure (SPAP) were measured.
• Conduction abnormalities (prolonged PR, wide QRS) were assessed and correlated with diastolic function and mortality.

Main Results:

• TAVI consistently reduced SPAP at 1 and 6 months.
• Increased LA volumes were observed at 1 month in patients with wide QRS and at 6 months with prolonged PR.
• Survival was not significantly affected by the presence of conduction abnormalities.

Conclusions:

• TAVI leads to a decrease in SPAP.
• Post-TAVI wide QRS with a normal PR interval may impair left-sided filling, increasing LA volume.
• Other diastolic parameters and survival are generally not significantly impacted by post-TAVI conduction abnormalities.