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Need for pacemaker implantation in patients with normal QRS duration immediately after transcatheter aortic valve implantation.

Authors :
Schoechlin S
Jalil F
Blum T
Ruile P
Hein M
Nührenberg TG
Arentz T
Neumann FJ
Source :
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2019 Dec 01; Vol. 21 (12), pp. 1851-1856.
Publication Year :
2019

Abstract

Aims: We sought to assess the need for permanent pacemaker implantation (PPI) in patients with QRS <120 ms in electrocardiogram (ECG) after transcatheter aortic valve implantation (TAVI).<br />Methods and Results: We retrospectively analysed 1139 consecutive patients who underwent transfemoral TAVI between 2008 and 2016, receiving different valve types. All patients were surveyed by continuous ECG monitoring for 48 h, 12-lead ECGs starting immediately after procedure, as well as 24-h Holter recording the day before discharge. Indication for PPI was at the discretion of the attending physician. Among 760 patients with QRS <120 ms prior to the TAVI procedure, 400 patients showed QRS <120 ms immediately after procedure, whereas 360 patients had QRS ≥120 ms. In the group with QRS <120 ms, PPI was performed in 34 patients [8.5%; 95% confidence interval (CI) 5.6-11.2%] during the first week. Eight of the PPIs in the group with QRS <120 ms (2%; CI 0.8-3.5%) fulfilled Class I indications for PPI after TAVI, whereas 26 PPIs had different indications [left bundle branch block, sick sinus, low-grade atrioventricular (AV) block]. Complete AV block developed in three patients of the group of QRS <120 ms (0.75%; CI 0.0-1.7%), which in all cases occurred after the 48 h-surveillance period. During 1-year follow-up, 11 PPIs were performed (2.8%; CI 1.2-4.5%), thereof three PPI for Class I indications including one complete AV block.<br />Conclusion: In patients with QRS duration <120 ms immediately after TAVI, the risk for complete AV block was low during the first week after TAVI and 1-year follow-up.<br /> (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)

Details

Language :
English
ISSN :
1532-2092
Volume :
21
Issue :
12
Database :
MEDLINE
Journal :
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Publication Type :
Academic Journal
Accession number :
31578544
Full Text :
https://doi.org/10.1093/europace/euz261