Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation
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Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation. / Bjerre Thygesen, Julie; Loh, Poay Huan; Cholteesupachai, Jiranut; Franzen, Olaf; Søndergård, Lars.
I: Journal of Invasive Cardiology, Bind 26, Nr. 2, 02.2014, s. 94-99.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation
AU - Bjerre Thygesen, Julie
AU - Loh, Poay Huan
AU - Cholteesupachai, Jiranut
AU - Franzen, Olaf
AU - Søndergård, Lars
PY - 2014/2
Y1 - 2014/2
N2 - AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period.METHODS AND RESULTS: A total of 258 consecutive patients underwent TAVI with the Medtronic CoreValve (MCV), whereas 24 patients were excluded from the study. TAVI-related PPM was defined as PPM implantation ≤30 days after the procedure and due to atrioventricular block (AVB). Third-degree AVB, second-degree type-II, or advanced second-degree AVB were considered as absolute indications for PPM. The incidence of TAVI-related PPM implantation was 27.4%. Forty-six patients (19.7%) had an absolute indication for PPM, but CA had resolved in 50% beyond the periprocedural period. Electrocardiographic analysis of the patients who did not have a TAVI-related PPM implantation showed that the PR and QRS intervals increased following TAVI, reaching a peak on days 4-6 and 7-9, respectively, before decreasing to near baseline levels.CONCLUSION: Although the incidence of periprocedural PPM implantation following TAVI was high, most CAs following TAVI tend to resolve after the periprocedural period. This suggests that delaying the decision for PPM implantation after TAVI may reduce the PPM rate.
AB - AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period.METHODS AND RESULTS: A total of 258 consecutive patients underwent TAVI with the Medtronic CoreValve (MCV), whereas 24 patients were excluded from the study. TAVI-related PPM was defined as PPM implantation ≤30 days after the procedure and due to atrioventricular block (AVB). Third-degree AVB, second-degree type-II, or advanced second-degree AVB were considered as absolute indications for PPM. The incidence of TAVI-related PPM implantation was 27.4%. Forty-six patients (19.7%) had an absolute indication for PPM, but CA had resolved in 50% beyond the periprocedural period. Electrocardiographic analysis of the patients who did not have a TAVI-related PPM implantation showed that the PR and QRS intervals increased following TAVI, reaching a peak on days 4-6 and 7-9, respectively, before decreasing to near baseline levels.CONCLUSION: Although the incidence of periprocedural PPM implantation following TAVI was high, most CAs following TAVI tend to resolve after the periprocedural period. This suggests that delaying the decision for PPM implantation after TAVI may reduce the PPM rate.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve
KW - Atrioventricular Block
KW - Cardiac Catheterization
KW - Denmark
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Heart Conduction System
KW - Heart Valve Prosthesis Implantation
KW - Humans
KW - Incidence
KW - Male
KW - Pacemaker, Artificial
KW - Retrospective Studies
KW - Severity of Illness Index
M3 - Journal article
C2 - 24486670
VL - 26
SP - 94
EP - 99
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
SN - 1042-3931
IS - 2
ER -
ID: 138132576