Computed Tomographic Predictors of Conduction Disturbances Following Transcatheter Aortic Valve Implantation

Background: It is not uncommon for patients who undergo TAVI to experience conduction abnormalities that require the placement of a new permanent pacemaker [PPM]. However, using a comprehensive multi-slice computed tomography [MSCT] analysis can aid in predicting and planning the procedure for optimal results.Aim of the work: Our objective was to examine the MSCT predictors of conduction disturbances that necessitate PPM after TAVI.Patients and Methods: We enrolled patients who had undergone TAVI with the Evolut platform. A comprehensive MSCT analysis was conducted, which included measuring the length of the membranous septum [MS], semi-quantitative analysis of the aortic leaflets, and assessment of mitral annulus calcification.Results: Among 100 patients [age, 81.8±5.1 years; 32% female, median EuroSCORE II 2.8[1.8, 4.4]], 10[10%] required PPM at discharge. Compared with patients who did not require a new PPM, those who did have shorter membranous septum [MS] length and more frequent ≥moderate mitral annular calcification.Conclusion: The length of the membranous septum and the severity of mitral annular calcification have been determined to be important factors in predicting the need for a permanent pacemaker implantation following transcatheter aortic valve implantation.