- 作者：Caroline Chong-Nguyen ; caroline.ng87@gmail.com" class="auth_mail" title="E-mail the corresponding author ; Nicolas Badenco ; Carole Maupain ; Olivier Barthé ; lé ; my ; Ré ; my Choussat ; Pascal Leprince ; Franç ; oise Hidden-Lucet ; Robert Frank ; Jean-Philippe Collet
- 刊名：Archives of Cardiovascular Diseases Supplements
- 出版年：2016
- 出版时间：April 2016
- 年：2016
- 卷：8
- 期：3
- 页码：225
- 全文大小：144 K
Methods Pacemaker
free patients who underwent TAVR from January 2013 to December 2014 were included. His bundle recording (HBR) was performed before TAVR (HV1), immediately after (HV2) and at day 2 for Sapiens valve or day 5 for Medtronic CoreValve (HV3). PPM was implanted if AVB occurred or HV3 > 80ms.
Results
84 patients (age 83±9 [mean±SD], Female 59%, Medtroncic Core- Valve 67%) were included. 28 PPM (33%) were implanted for documented AVB (n=17), prolonged HV interval (n=9) or sick sinus syndrome (n=2). High degree AVB after discharge was observed in 13 patients (17.8%). The mean of HV1, HV2 and HV3 were 56ms±10, 71ms ±20 and 63ms ±14, respectively. There was no correlation between HV1, HV2 or HV3 with AVB. Preoperative right bundle branch block (RBBB) and AVB during TAVR were associated with early AVB (respectively p=0.03, p=0.002), leading to prolonged monitoring (fig1). Early post-operative AVB was associated with late AVB (p<0.001).
Conclusions
Repeated HBR did not provide any guidance for PPM implantation. RBBB and peroperative high degree AVB are risk factors for AVB after TAVR. Early post-operative AVB is a strong predictive factor of long term recurrence AVB and should be considered for the decision of PPM implantation.
- Figure.
algorithm of patient's monitoring before and after TAVR. AVB = atrioventricular block, D=day, TAVR = transcatheter aortic valve replacement
The author hereby declares no conflict of interest