Incidence of Conduction Disorders and Requirements for Permanent Pacemaker After Transcatheter Aortic Valve Implantation
Int. j. cardiovasc. sci. (Impr.)
;
32(5): 492-504, Sept-Oct. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1040093
ABSTRACT
Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for high-risk or non-operable patients with severe symptomatic aortic stenosis. Atrioventricular conduction disturbances requiring permanent pacemaker (PPM) are a common and clinically important complication. Objectives:
To evaluate the incidence of conduction disorders (CDs) after TAVI and the need for subsequent PPM implantation. To identify the predictors of postoperative PPM implantation.Methods:
Retrospective study. All patients who underwent TAVI in a public hospital from December/2011 to June/2016 were included. Multivariate analysis was conducted to establish the predictor of permanent pacemaker implantation. Survival curves were constructed by the Kaplan-Meyer method. Statistically significant variables were those with p value < 0.05.Results:
64 patients with AS underwent TAVI. Eleven patients were excluded. TAVI induced a new CD in 40 (77%) of the remaining 53 patients. The most common new CDs were 3rd degree AV block (32%) and left bundle branch block (30%). Sixteen patients (30,2%) underwent PPM implantation during the index hospitalization. On univariate analysis the risk factors for PPM implantation were CoreValve® use (OR 1,76; P = 0,005), larger prosthesis implantation (P = 0,015), presence of a QRS ≥ 120 ms (OR 5,62; P = 0,012), and 1st degree AV block (OR 13; P = 0.008). On multivariate analysis the presence of 1st degree AV block predicted the need for PPM.Conclusion:
TAVI induced CDs requiring PPM in 30% of the patients. The presence of 1st degree AV block predicted the need for PPM
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Aortic Valve Stenosis
/
Pacemaker, Artificial
/
Bundle-Branch Block
/
Transcatheter Aortic Valve Replacement
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2019
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Nacional de Cardiologia/BR
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