Document Detail


Patients without prolonged QRS after TAVI with corevalve device do not experience high degree atrio-ventricular block.
MedLine Citation:
PMID:  22972678     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To identify clinical and electrical factors predicting delayed high degree atrio-ventricular block (AVB) after transcatheter aortic valve implantation (TAVI). BACKGROUND: TAVI is a new technique for treating severe aortic valve stenosis in patients at high surgical risk but can be followed by high grade AVB requiring permanent pacing. METHODS AND RESULTS: The study included 79 patients (82±17 years, Euroscore=23±10 %) free of permanent pacing need before and immediately after TAVI procedure. Delayed high degree AVB was defined by type 2 or 3 AVB diagnosed at least 24 hours after the index procedure. Permanent pace maker implantation was performed for all these patients. We compared clinical and electrical variables before and after TAVI in patients with delayed AVB or not. TAVI was performed successfully in all patients. The 21 (26%) patients who exhibited delayed high grade AVB had significantly deeper prosthesis implantation (12±4 mm vs. 9±5 mm, P=0.03) and wider post-TAVI QRS duration (155±17 ms vs. 131±25 ms, P=0.0004), with no difference in baseline QRS duration. Post-TAVI QRS duration was the only independent predictor of post-TAVI permanent for delayed high degree AVB (P=0.02). After a mean follow-up of 10±8 months, all 21 patients with post-TAVI QRS ≤128 ms were free of high-grade AVB, while 21/55 (38%) patients with post-TAVI QRS >128 ms had permanent pacing (P=0.0016). CONCLUSION: Delayed ( 24 hours after the procedure) high-grade AVB necessitating permanent pacing is common after TAVI. QRS duration measured immediately after TAVI was the best independent predictor of permanent pacing in this population. Patients with QRS ≤128 ms immediately after TAVI had no risk of requiring permanent pacing. © 2012 Wiley Periodicals, Inc.
Authors:
Gauthier Mouillet; Nicolas Lellouche; Pascal Lim; Kentaro Meguro; Masanori Yamamoto; Jean-François Deux; Jean-Luc Monin; Eric Bergoënd; Jean-Luc Dubois-Randé; Emmanuel Teiger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-13
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Cardiology Department Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris & INSERM U 955, 51 Avenue du Maréchal de Lattre de Tassigny 94000 CRETEIL, FRANCE. gauthier.mouillet@hmn.aphp.fr.
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