Transcatheter aortic valve implantation improves left ventricular function and hemodynamics and reduces severe ventricular arrhythmias in patients with severe aortic stenosis

OBJECTIVE: To assess changes in LV function, hemodynamics, and ventricular arrhythmias (VAs) after transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS) patients at 1-month and 1-year follow-up. METHODS: Eighty severe AS patients undergoing TAVI were analyzed after exclusions (prior pacemaker, post-TAVI complications, death, or missing data). Echocardiography (left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD], mean transaortic gradient), NT-proBNP levels, and 24-h Holter monitoring (modified Lown grading for VAs) were evaluated pre-TAVI, at 1 month, and 1 year post-TAVI. RESULTS: At 1 month, LVEF improved from 41.5 ± 7.8% to 48.0 ± 6.0% (P = 0.034), LVEDD decreased from 56.6 ± 11.5 mm to 54.0 ± 11.0 mm (P = 0.020), and mean gradient dropped from 54.8 ± 9.5 mmHg to 18.2 ± 4.5 mmHg (P < 0.001). NT-proBNP decreased from 3870 pg/mL (IQR: 780–26500) to 1015 pg/mL (IQR: 550–8500) (P < 0.01). Lown grade 3–4 VAs declined from 33.8% to 17.5% (P = 0.030). At 1 year, LVEF further improved to 51.5 ± 5.5% (P < 0.001), LVEDD to 52.5 ± 10.8 mm (P < 0.01), and mean gradient to 15.5 ± 4.0 mmHg (P < 0.001). NT-proBNP remained low (850 pg/mL, IQR: 450–15500; P < 0.001), and Lown 3–4 VAs decreased to 12.5% (P < 0.001). Ventricular tachycardia incidence reduced from 12.5% pre-TAVI to 5.0% at 1 year (P = 0.016). CONCLUSION: TAVI significantly improves LV function, promotes reverse remodeling, and reduces severe VAs in severe AS patients, with sustained benefits at 1 year, highlighting its positive impact on cardiac structure, function, and arrhythmic burden.