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Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation
François Damas1, Mai-Linh Nguyen Trung1, Adriana Postolache1
1Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium.
Journal of Clinical Medicine
|January 23, 2024
Summary
The Aortic Stenosis-related Cardiac Damage Staging (ASCDS) system may predict conduction disorders after transcatheter aortic valve implantation (TAVI). Higher ASCDS grades correlate with increased risks of new left bundle branch block, atrial fibrillation, and permanent pacemaker implantation.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
Background:
- Aortic stenosis (AS) is a significant cardiovascular condition.
- A new staging system, AS-related cardiac damage staging (ASCDS), quantifies cardiac damage in AS.
- ASCDS is linked to mortality and adverse clinical outcomes.
Purpose of the Study:
- To investigate the association between ASCDS and conduction system disorders following transcatheter aortic valve implantation (TAVI).
Main Methods:
- 119 patients with severe AS undergoing TAVI were stratified into three groups based on ASCDS.
- Conduction disorders including new left bundle branch block (LBBB), high-degree atrioventricular block (HD-AVB), and paroxysmal atrial fibrillation (AF) were assessed post-TAVI.
- Rates of permanent pacemaker implantation (PPMI) were compared across ASCDS groups.
Main Results:
- 34% of patients developed new LBBB, and 10% developed HD-AVB after TAVI.
- No HD-AVB occurred in the lowest ASCDS group; LBBB was frequent in higher grade groups.
- Paroxysmal AF and PPMI rates increased significantly with higher ASCDS grades (p=0.012 for both).
Conclusions:
- ASCDS may serve as a valuable tool for identifying patients at elevated risk of post-TAVI conduction abnormalities.
- The staging system could aid in predicting the need for permanent pacemaker implantation after TAVI.
