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Hisian Lead Electrical Decay After TAVR Intervention.
Alessandro Faggi1, Nicola Buzzatti1, Alessandra Marzi1
1Vita Salute San Raffaele University, Milan, Italy.
A patient with a Hisian pacemaker experienced complete atrioventricular block after transcatheter aortic valve replacement. This required lead extraction and pacemaker revision for optimal cardiac function.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Interventional Cardiology
Background:
- Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for aortic stenosis.
- Pacemakers are crucial for managing bradyarrhythmias and conduction disorders.
- Hisian pacing offers an alternative to biventricular pacing, preserving native ventricular activation.
Observation:
- A patient with a pre-existing single-chamber Hisian pacemaker developed complete atrioventricular block post-TAVR.
- Significant deterioration in ventricular lead threshold and sensing parameters was noted after the procedure.
Findings:
- The Hisian pacemaker lead malfunctioned, leading to complete heart block.
- Ventricular lead performance degraded substantially following TAVR.
Implications:
- TAVR can potentially interfere with the function of pre-existing Hisian pacemakers.
- Close monitoring of pacemaker function is essential after TAVR in patients with Hisian leads.
- Lead extraction and replacement may be necessary to restore effective pacing.
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