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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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Prosthesis-patient mismatch with intra-annular self-expanding valves: an analysis of the PORTICO IDE trial.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·2026
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First Large Comprehensive Core-Laboratory Evaluation of Implantation Depth and Clinical Outcomes in TAVR: Final Global Results from the Optimize PRO Prospective Study.

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Bicuspid Aortic Valve Leaflet Modification Before Transcatheter Aortic Valve Replacement: A New Paradigm.

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Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
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Management of Postprocedural Conduction Disturbances Using a Prespecified Algorithm in the Optimize PRO Study.

Kendra J Grubb1, Steven J Yakubov2, Tamim M Nazif3

  • 1Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed
Summary
This summary is machine-generated.

A standardized algorithm for managing conduction disturbances after transcatheter aortic valve replacement (TAVR) effectively identifies patients needing pacemakers, ensuring safe monitoring and similar outcomes to those without disturbances.

Keywords:
conduction disturbance algorithmleft bundle branch blockpermanent pacemaker implantationtranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Standardization in identifying and managing post-TAVR conduction disturbances (CD) is lacking, potentially impacting permanent pacemaker implantation (PPI) rates and clinical outcomes.
  • The safety and efficacy of a standardized TAVR CD algorithm have not been previously analyzed.
  • This study evaluates the Optimize PRO post-TAVR CD management algorithm in conjunction with Evolut PRO/PRO+ valves.

Purpose of the Study:

  • To analyze the safety and efficacy of the Optimize PRO post-TAVR CD management algorithm.
  • To assess the impact of a standardized algorithm on PPI rates and clinical outcomes following TAVR.
  • To evaluate the effectiveness of the cusp overlap technique and a post-TAVR CD algorithm in reducing pacemaker rates.

Main Methods:

  • Prospective, postmarket study (Optimize PRO) employing cusp overlap technique and a post-TAVR CD algorithm.
  • Patients underwent a 2-hour postprocedural ECG, stratified for discharge or CD algorithm based on ECG findings.
  • CD algorithms addressed preexisting or new bundle branch block (LBBB) and atrioventricular block (AVB).

Main Results:

  • Interim analysis included 125 TAVR recipients with conduction disturbances (CD).
  • The 30-day new PPI rate was 28.1% in the CD cohort versus 1.5% in controls (P <.001).
  • Among patients discharged with monitors, 90% did not require PPI; clinical outcomes were similar between patients with and without CDs.

Conclusions:

  • The standardized CD algorithm for Evolut TAVR demonstrates safe 30-day outcomes comparable to patients without CDs.
  • This algorithm may effectively identify arrhythmias early, optimize PPI utilization, and enable safe post-discharge monitoring.
  • No sudden cardiac death occurred in the analyzed cohort.