RT Journal Article
SR Electronic
T1 Late onset of new conduction disturbances requiring permanent pacemaker implantation following TAVI
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1244
OP 1251
DO 10.1136/heartjnl-2019-315967
VO 106
IS 16
A1 Nynke H M Kooistra
A1 Martijn S van Mourik
A1 Ramón Rodríguez-Olivares
A1 Alexander H Maass
A1 Vincent J Nijenhuis
A1 Rik van der Werf
A1 Jurrien M ten Berg
A1 Adriaan O Kraaijeveld
A1 Jan Baan Jr
A1 Michiel Voskuil
A1 M Marije Vis
A1 Pieter R Stella
YR 2020
UL http://heart.bmj.com/content/106/16/1244.abstract
AB Background The timing of onset and associated predictors of late new conduction disturbances (CDs) leading to permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI) are still unknown, however, essential for an early and safe discharge. This study aimed to investigate the timing of onset and associated predictors of late onset CDs in patients requiring PPI (LCP) following TAVI.Methods and results We performed retrospective analysis of prospectively collected data from five large volume centres in Europe. Post-TAVI electrocardiograms and telemetry data were evaluated in patients with a PPI post-TAVI to identify the onset of new advanced CDs. Early onset CDs were defined as within 48 hours after procedure, and late onset CDs as after 48 hours. A total of 2804 patients were included for analysis. The PPI rate was 12%, of which 18% was due to late onset CDs (>48 hours). Independent predictors for LCP were pre-existing non-specific intraventricular conduction delay, pre-existing right bundle branch block, self-expandable valves and predilation. At least one of these risk factors was present in 98% of patients with LCP. Patients with a balloon-expandable valve without predilation did not develop CDs requiring PPI after 48 hours.Conclusions Safe early discharge might be feasible in patients without CDs in the first 48 hours after TAVI if no risk factors for LCP are present.