Bedside Electrophysiological Study Using a Temporary Pacemaker May Predict Recurrence of Atrioventricular Block After Transcatheter Aortic Valve Replacement
| Autor: | Takahide Nakano, Yosuke Honda, Tsuyoshi Sakai, Kenji Makino, Masahiro Yamawaki, Yoshiaki Ito, Masahiro Nauchi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ejection fraction Transcatheter aortic Heart block business.industry medicine.medical_treatment General Medicine medicine.disease Procainamide Electrophysiology Valve replacement Internal medicine medicine Cardiology Cardiology and Cardiovascular Medicine business Complication Atrioventricular block medicine.drug |
| Zdroj: | International Heart Journal. 62:1012-1018 |
| ISSN: | 1349-3299 1349-2365 |
| Popis: | High-degree atrioventricular block (HAVB) or complete heart block (CHB) is a common complication associated with transcatheter aortic valve replacement (TAVR). However, some patients with HAVB/CHB recover with time. The results of electrophysiological studies (EPSs) using permanent pacemaker implantation (PPI) in patients with suspicious HAVB/CHB are considered controversial.This study aimed to evaluate whether HAVB/CHB induction at the bedside using a temporary pacemaker can predict recurrence in patients who had recovered from HAVB/CHB after TAVR.We enrolled a total of 11 patients who had recovered from HAVB/CHB and evaluated their electrophysiology using right ventricular pacing and/or procainamide administration.HAVB/CHB induction was positive. Three patients tested positive for HAVB/CHB, whereas 8 tested negative. The ejection fraction and the interval between HAVB/CHB onset and EPS were found to be significant. HAVB/CHB positive patients underwent PPI. A patient with a balloon-expandable valve tested positive just before recovery of CHB, but tested negative 5 days later and was included in the negative group. The 4 patients who tested negative received a cardiovascular implantable electric device (CIED). We observed HAVB/CHB in 2 patients who had previously tested positive after 3 months. Among those who tested negative, those with CIED had no HAVB/CHB, and others showed neither HAVB/CHB on electrocardiogram nor experienced syncope or sudden death.Our EPS revealed that HAVB/CHB induction may predict HAVB/CHB recurrence after TAVR. Valve type and EPS timing may affect the results. |
| Databáze: | OpenAIRE |
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