Evaluation of the incidence, timing, and potential recovery rates of complete atrioventricular block after transcatheter aortic valve implantation: a Japanese multicenter registry study.
Aged, 80 and over
Aortic Valve Stenosis
/ surgery
Atrioventricular Block
/ epidemiology
Female
Heart Rate
/ physiology
Humans
Incidence
Japan
/ epidemiology
Male
Pacemaker, Artificial
Postoperative Complications
/ epidemiology
Recovery of Function
Registries
Transcatheter Aortic Valve Replacement
/ adverse effects
Complete atrioventricular block
Pacemaker
Transcatheter aortic valve implantation
Journal
Cardiovascular intervention and therapeutics
ISSN: 1868-4297
Titre abrégé: Cardiovasc Interv Ther
Pays: Japan
ID NLM: 101522043
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
18
06
2019
accepted:
04
05
2020
pubmed:
18
5
2020
medline:
29
6
2021
entrez:
18
5
2020
Statut:
ppublish
Résumé
Data on the accurate onset date and serial changes of the complete atrioventricular block (CAVB) after transcatheter aortic valve implantation (TAVI) are limited. This study aimed to assess the incidence, timing, and potential recovery of CAVB following TAVI. Total 696 patients who underwent TAVI were enrolled. Acute CAVB was evaluated within 24 h; delayed CAVB was evaluated 24 h after TAVI. Recovered CAVB was defined as ventricular pacing < 1% during the follow-up or transit block without the need for permanent pacemaker implantation (PMI). The other patients with CAVB were categorized as continued CAVB. Clinical differences between the recovered and continued CAVB groups were evaluated, and the predictive factors of continued CAVB were assessed. The incidence rates of CAVB, acute CAVB, and delayed CAVB were 6.9% (48/696), 4.6% (32/696), and 2.3% (16/696), respectively. Overall, 47.9% (23/48) of patients had recovered CAVB, which was more prevalent in the acute CAVB group than in the delayed CAVB group [59.4% (19/32) vs. 25.0% (4/16), p = 0.025]. CAVB recovery occurred within 24 h (61.0%, 14/23) and after 24 h (39.0%, 9/23). Before CAVB recovery, 21.7% (5/23) of patients had already undergone PMI. A pre-existing complete right bundle branch block (CRBBB) was the only independent predictive factor of continued CAVB (odds ratio 4.51, 95% confidence interval 1.03-19.6, p = 0.045). In conclusion, a pre-existing CRBBB and the timing and prolonged duration of CAVB may be used in risk stratification to determine the appropriateness of early discharge, optimal PMI date, and PMI indication.
Identifiants
pubmed: 32418052
doi: 10.1007/s12928-020-00670-6
pii: 10.1007/s12928-020-00670-6
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
246-255Références
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