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Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation.

Gaetano Pinnacchio1, Eleonora Ruscio1, Erica Rocco1

  • 1Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy.

Journal of Cardiovascular Development and Disease
|October 26, 2022
PubMed
Summary

Many patients receiving a permanent pacemaker after transcatheter aortic valve implantation recover atrioventricular conduction. Longer observation before pacemaker implantation may be beneficial.

Keywords:
AV conduction abnormalitiesAV conduction recoveryAV dysfunction after TAVITAVIpermanent pacemaker implantation

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Permanent pacemaker implantation (PPI) is a common complication following transcatheter aortic valve implantation (TAVI).
  • Atrioventricular (AV) node injury is the primary cause of PPI after TAVI.
  • Predicting early recovery of AV conduction is crucial for patient management.

Purpose of the Study:

  • To investigate predictors of early atrioventricular (AV) function recovery after permanent pacemaker implantation (PPI) in patients who underwent transcatheter aortic valve implantation (TAVI).

Main Methods:

  • Analysis of 50 consecutive patients undergoing PPI post-TAVI.
  • Pacemaker interrogations within 4–6 weeks to assess AV conduction.
  • Multivariate analysis to identify predictors of pacemaker dependency and AV conduction recovery.

Main Results:

  • 26% of patients recovered AV conduction within 4–6 weeks.
  • Complete atrioventricular block independently predicted pacemaker dependency (p = 0.019).
  • Patients with persistent AV dysfunction showed prolonged PR and QRS intervals post-TAVI compared to those with recovery.

Conclusions:

  • A significant proportion of patients undergoing PPI after TAVI experience AV conduction recovery.
  • Complete AV block is a strong predictor of long-term pacemaker dependency.
  • Consideration of longer observation periods before PPI and minimizing ventricular pacing may be warranted.