| Autor: |
Baptiste Maille, Marine Bouchat, Nicolas Dognin, Pierre Deharo, Noémie Rességuier, Frédéric Franceschi, Linda Koutbi-Franceschi, Jérôme Hourdain, Elisa Martinez, Maxime Zabern, Thomas Cuisset, Jean-Claude Deharo |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
International Journal of Cardiology: Heart & Vasculature, Vol 39, Iss , Pp 100961- (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2352-9067 |
| DOI: |
10.1016/j.ijcha.2022.100961 |
| Popis: |
Aims: Electrophysiological study (EPS) is recommended in case of new-onset persistent left bundle branch block (NOP-LBBB) after transaortic valve implantation (TAVI) to identify patients at high risk of delayed atrioventricular block (D-AVB). We evaluated the added value of drug challenge, after normal baseline EPS, to predict D-AVB in such patients. Methods: We conducted a comparative single-centre study of two successive periods, during which we used baseline EPS alone (first period) or drug challenge in case of normal baseline EPS (second period), for patients with NOP-LBBB after TAVI. The primary endpoint was a composite of pacemaker use, documented D-AVB, cardiac syncope, sudden death, or delayed pacemaker implantation. Results: Among 736 patients with TAVI implantation between January 2016 and September 2019, 64 with NOP-LBBB were included. During the first period, 4/22 (18.2%) presented with a positive baseline EPS. After a mean (standard deviation [SD]) of 15.6 (8.3) months, 7/22 (31.8%) reached the primary endpoint. During the second period, 19/42 (45.2%) presented with a positive EPS. After a mean (SD) of 12.8 (3.5) months, 8/42 (19.0%) reached the primary endpoint. There was a tendency to increased sensitivity (42.9–87.5%; P = 0.12) and negative predictive value (77.8–95.7%; P = 0.15) of the EPS, respectively during the first to the second period. However, the specificity decreased (93.3–64.7%; P = 0.04). Conclusion: Diagnostic yield improved with drug challenge in case of normal baseline EPS. However, the decrease in specificity led to a high rate of unnecessary pacemaker implantation. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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