Transient and persistent conduction abnormalities following transcatheter aortic valve replacement with the Edwards-Sapien prosthesis: a comparison between antegrade vs. retrograde approaches
| Autor: | Carlos Alfonso, Solomon J. Sager, Claudia Martinez, Abdulla A. Damluji, Donald Williams, Mauricio G. Cohen, Roger G. Carrillo, Alan W. Heldman, Robert J. Myerburg, Joshua A Cohen, Brian P. O'Neill, Sachil Shah |
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| Rok vydání: | 2016 |
| Předmět: |
Aortic valve
Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Prosthesis Design Transcatheter Aortic Valve Replacement 03 medical and health sciences QRS complex 0302 clinical medicine Postoperative Complications Valve replacement Risk Factors Physiology (medical) Internal medicine medicine Humans 030212 general & internal medicine PR interval Risk factor Prospective cohort study Aged 80 and over Left bundle branch block business.industry Incidence Arrhythmias Cardiac Equipment Design medicine.disease Equipment Failure Analysis Survival Rate medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis Acute Disease Chronic Disease Cardiology Florida Female Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 47(2) |
| ISSN: | 1572-8595 |
| Popis: | Electrocardiographic conduction abnormalities following transcatheter aortic valve replacement (TAVR) with the Edwards-Sapien valve (ESV) are not uncommon and may be transient. We sought to examine the clinical time-course of conduction abnormalities after TAVR with ESV and determine risk factors for persistent abnormalities. In this single-center prospective study, 116 consecutive patients underwent implantation of the ESV after approval by the Food and Drug Administration (FDA). Demographic, clinical, and intra-procedural variables were collected in a registry, including ECGs before, immediately after, and at discharge from hospital. Conduction abnormalities were analyzed including PR interval lengthening, QRS widening, left bundle branch block (LBBB), and high-grade AV block. There were 92 patients included in the analysis. A total of 41 new conduction abnormalities were observed in 31 (34 %) patients: 7 new PR prolongation, 14 QRS widening, 14 new LBBB, and 5 high-grade AV block requiring permanent pacemaker. Of the 41 new CAs, 11 (27 %) were transient; of the transient abnormalities, 9 (82 %) resolved within 24 h of the index procedure. Chronic kidney disease was a risk factor for the development of a persistent abnormality and for need for PPM. Antegrade approach was associated with the development of persistent LBBB and persistent QRS widening. A significant proportion of conduction abnormalities after ESV implantation improved prior to discharge from the hospital, usually within 24 h. CKD is associated with persistence of abnormalities and with need for PPM. Antegrade approach increases risk for new intraventricular conduction delays, including LBBB. |
| Databáze: | OpenAIRE |
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