Atrioventricular conduction in PM recipients after transcatheter aortic valve implantation: Implications using Wenckebach point measurement.
Wenckebach point
atrioventricular conduction
pacing
personalized medicine
transcatheter aortic valve implantation (TAVI)
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2022
2022
Historique:
received:
25
03
2022
accepted:
04
07
2022
entrez:
8
8
2022
pubmed:
9
8
2022
medline:
9
8
2022
Statut:
epublish
Résumé
Atrioventricular (AV) conduction disturbances requiring permanent pacemaker implantation (PPI) are a common complication after transcatheter aortic valve implantation (TAVI). However, a significant proportion of patients might recover AV conduction at follow-up. The aim of our study was to evaluate the recovery of AV conduction by determination through Wenckebach point in patients with PPI and therefore identify patients who could benefit from device reprogramming to avoid unnecessary RV pacing. We enrolled 43 patients that underwent PM implantation after TAVI at our Department from January 2018 to January 2021. PM interrogation was performed at follow-up and patients with native spontaneous rhythm were further assessed for AV conduction through WP determination. A total of 43 patients requiring a PM represented the final study population, divided in patients with severely impaired AV conduction (no spontaneous valid rhythm or WP < 100; 26) and patients with valid AV conduction (WP ≥ 100; 17). In the first group patients had a significantly higher number of intraprocedural atrioventricular block (AVB) (20 vs. 1, AV conduction may recover in a significant proportion of patients. In our study, valve implantation depth in the LVOT and intraprocedural AV block are associated with severely impaired AV conduction. Regular PM interrogation and reprogramming are required to avoid unnecessary permanent right ventricular stimulation in patients with AV conduction recovery.
Sections du résumé
Background
UNASSIGNED
Atrioventricular (AV) conduction disturbances requiring permanent pacemaker implantation (PPI) are a common complication after transcatheter aortic valve implantation (TAVI). However, a significant proportion of patients might recover AV conduction at follow-up.
Objectives
UNASSIGNED
The aim of our study was to evaluate the recovery of AV conduction by determination through Wenckebach point in patients with PPI and therefore identify patients who could benefit from device reprogramming to avoid unnecessary RV pacing.
Methods
UNASSIGNED
We enrolled 43 patients that underwent PM implantation after TAVI at our Department from January 2018 to January 2021. PM interrogation was performed at follow-up and patients with native spontaneous rhythm were further assessed for AV conduction through WP determination.
Results
UNASSIGNED
A total of 43 patients requiring a PM represented the final study population, divided in patients with severely impaired AV conduction (no spontaneous valid rhythm or WP < 100; 26) and patients with valid AV conduction (WP ≥ 100; 17). In the first group patients had a significantly higher number of intraprocedural atrioventricular block (AVB) (20 vs. 1,
Conclusion
UNASSIGNED
AV conduction may recover in a significant proportion of patients. In our study, valve implantation depth in the LVOT and intraprocedural AV block are associated with severely impaired AV conduction. Regular PM interrogation and reprogramming are required to avoid unnecessary permanent right ventricular stimulation in patients with AV conduction recovery.
Identifiants
pubmed: 35935649
doi: 10.3389/fcvm.2022.904828
pmc: PMC9353552
doi:
Types de publication
Journal Article
Langues
eng
Pagination
904828Informations de copyright
Copyright © 2022 Pelargonio, Scacciavillani, Donisi, Narducci, Aurigemma, Pinnacchio, Bencardino, Perna, Spera, Comerci, Ruscio, Romagnoli, Crea, Burzotta and Trani.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Europace. 2013 Aug;15(8):1070-118
pubmed: 23801827
J Interv Card Electrophysiol. 2018 Jan;51(1):77-86
pubmed: 29260369
Catheter Cardiovasc Interv. 2020 Aug;96(2):459-470
pubmed: 31925991
J Electrocardiol. 2017 Jul - Aug;50(4):389-399
pubmed: 28341304
JACC Clin Electrophysiol. 2017 Nov;3(11):1296-1305
pubmed: 29759627
Circ Arrhythm Electrophysiol. 2021 Jan;14(1):e009028
pubmed: 33306415
Eur Heart J. 2019 Oct 7;40(38):3143-3153
pubmed: 31329852
Heart. 2004 Jun;90(6):661-6
pubmed: 15145874
N Engl J Med. 2019 May 2;380(18):1695-1705
pubmed: 30883058
Circ Cardiovasc Interv. 2021 Jan;14(1):e009407
pubmed: 33430603
Clin Res Cardiol. 2018 Jan;107(1):60-69
pubmed: 28963581
Clin Cardiol. 2020 Nov;43(11):1334-1342
pubmed: 32886389
JAMA Netw Open. 2018 May 18;1(1):e180088
pubmed: 30646053
Pacing Clin Electrophysiol. 2019 Oct;42(10):1347-1354
pubmed: 31429947
Catheter Cardiovasc Interv. 2018 Dec 1;92(7):1380-1386
pubmed: 29536613
Europace. 2021 Dec 7;23(12):1998-2009
pubmed: 34379760
JACC Cardiovasc Interv. 2020 Mar 23;13(6):679-688
pubmed: 31838114
J Med Econ. 2019 Nov;22(11):1171-1178
pubmed: 31373521
J Am Coll Cardiol. 2019 Aug 27;74(8):1086-1106
pubmed: 31439219
Front Cardiovasc Med. 2021 May 04;8:653768
pubmed: 34017866
J Am Coll Cardiol. 2019 Aug 20;74(7):e51-e156
pubmed: 30412709
N Engl J Med. 2019 May 2;380(18):1706-1715
pubmed: 30883053
EuroIntervention. 2019 Nov 20;15(10):875-883
pubmed: 31217147
Heart. 2015 Oct;101(20):1665-71
pubmed: 26261157
Eur Heart J. 2011 Aug;32(16):2067-74
pubmed: 21622979
Circ Cardiovasc Interv. 2017 Jul;10(7):
pubmed: 28698290
Eur Heart J. 2021 Sep 14;42(35):3427-3520
pubmed: 34455430
Heart. 2009 Jan;95(1):43-8
pubmed: 18208829
Catheter Cardiovasc Interv. 2020 Apr 1;95(5):982-990
pubmed: 31037836
J Am Coll Cardiol. 2020 Nov 17;76(20):2391-2411
pubmed: 33190683
JAMA Cardiol. 2016 Apr 1;1(1):46-52
pubmed: 27437653