Atrioventricular and intraventricular block after transcatheter aortic valve implantation

Lee, Jane; Goldschlager, Nora; Mahadevan, Vaikom S.

doi:10.1007/s10840-018-0391-6

Cited by 8 publications

(3 citation statements)

References 49 publications

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“…Although there are some identified risk factors for pacemaker implantation, such as preoperative conduction disturbances and type of prosthesis, the cause of complete atrioventricular block after TAVR is unknown [ 4 - 5 ]. However, due to the anatomical proximity between the aortic valve and the atrioventricular node as well as the His bundle, direct mechanical trauma produced by valve prostheses, catheters, or wires may cause local inflammation, edema, or ischemia and damage to the cardiac conduction system [ 6 ]. Furthermore, the atrioventricular block is often transient, which led to the hypothesis that the use of corticosteroids prior to the procedure could reduce tissue edema and fibrosis related to inflammation and hence the incidence of conduction disturbances and pacemaker implantation [ 7 - 8 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Corticosteroids and Pacemaker Implantation After Transcatheter Aortic Valve Replacement

Tiago,

Dias Vaz,

Marques

et al. 2024

Cureus

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Background: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis. However, conduction disturbances leading to pacemaker implantation remain a common complication, increasing morbidity and mortality in these patients. Hence, measures to lower its incidence should be taken, and corticosteroid therapy could be effective by reducing inflammation caused by direct mechanical trauma to the conduction system. Methods: A retrospective cohort study was conducted at the Centro Hospitalar de Vila Nova de Gaia/Espinho, analyzing the medical records of patients with native severe aortic stenosis who underwent transfemoral TAVR in 2022. The Chi-square test was used to compare the rate of pacemaker implantation in patients who received corticosteroids with patients who didn't. The statistical significance was considered for a p-value <0.05. Results: A total of 341 patients were included in this study. Monitored anesthesia care was the preferred anesthetic technique (99.1%). Sixty-three point three percent (63.3%) of patients received corticosteroids at the beginning of the procedure. Corticosteroid administration did not significantly affect the incidence of permanent pacemaker implantation (p=0.277), vascular complications on the access site (p=0.765), or in-hospital mortality (p=0.909). Male gender, 1st-degree atrioventricular block, and right branch block were the only identified predictors of permanent pacemaker implantation after transfemoral TAVR (p=0.041 <0.001 and <0.001, respectively). Conclusion: Corticosteroid administration at the beginning of TAVR doesn’t seem to influence the incidence of permanent pacemaker implantation, which can suggest that other factors play a more important role in the development of conduction disturbances leading to pacemaker implantation.

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Section: Introductionmentioning

confidence: 99%

Intraoperative Corticosteroids and Pacemaker Implantation After Transcatheter Aortic Valve Replacement

Tiago,

Dias Vaz,

Marques

et al. 2024

Cureus

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“…However, the technology has many contraindications, and the cooperation of the examinee is required [ 19 ]. MSCT combines the advantages of ultrasound and MRI technology, can clearly show the structure and spatial relationship of normal tissue and lesion tissue, and is widely used in assessing the degree of calcification and valve stenosis in AS patients [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence-Based Spiral CT 3D Reconstruction in Transcatheter Aortic Valve Implantation

Zhang

Gao

et al. 2022

Computational and Mathematical Methods in Medicine

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To evaluate the clinical application effect of spiral computed tomography (CT) three-dimensional (3D) reconstruction based on artificial intelligence in transcatheter aortic valve implantation (TAVI), a CT 3D reconstruction model based on deep convolutional neural networks (DCNN) was established in this research, which was compared with the model-based iterative reconstruction (MBIR) and used in clinical practice. Then, 62 patients with aortic stenosis (AS) who underwent TAVI surgery were recruited as the research objects. The accuracy, sensitivity, and specificity of the multislice spiral CT scan (MSCT) and transthoracic echocardiography (TTE) in predicting the type of TAVI surgical valve were compared and analyzed. The results showed that the mean absolute error (MAE) (0.01) and root mean square error (RMSE) (0.086) of the MBIR model were higher than the reconstruction model in this research. The structural similarity (SSIM) (0.831) and peak signal-to noise ratio (PSNR) (32.77 dB) of the MBIR model were lower than the reconstruction model, and the differences were considerable ( P < 0.05 ). Of the valve models selected based on the TTE measurement results, 35 cases were accurately predicted and 27 cases were incorrectly predicted. The accuracy of MSCT was 87.1%, the specificity was 98.84%, and the sensitivity was 92.87%; all of which were significantly higher than TTE ( P < 0.05 ). In summary, compared with the MBIR reconstruction model, the imaging results of the model established in this research were closer to the real image. Compared with TTE, MSCT had higher accuracy, sensitivity, and specificity and can provide more accurate preoperative predictions for patients undergoing TAVI surgery.

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“…Well‐recognized predictors for permanent pacemaker implantation (PMI) post‐TAVR include male sex, preexisting right bundle branch block, first‐degree atrioventricular block, left anterior hemiblock, use of self‐expanding valves, and intraoperative AV block 1–4 . The location of complete heart block post‐TAVR has been noted to occur both at the level of the AV node and in the His‐Purkinje system (infra AV node) 5–7 . The majority of CD post‐TAVR warranting PMI occurs within the first 7 days, however late occurring CD has also been described 8–9 .…”

Section: Introductionmentioning

confidence: 99%

Late onset complete heart block after transcatheter aortic valve replacement treated with permanent His‐bundle pacing

Patel

Jamoor

Khan

et al. 2020

Pacing Clinical Electrophis

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Transcatheter aortic valve replacement (TAVR) is a rapidly growing procedure. Conduction disease post‐TAVR is frequent and routinely monitored for periprocedurally. Permanent pacemaker placement is relatively common and usually associated with worse outcomes post‐TAVR. We report a case of very late presenting complete heart block post‐TAVR treated with His‐bundle pacing. Our case underscores the need for larger studies to further evaluate the utility of long‐term cardiac monitoring post‐TAVR and outcomes of His‐bundle pacing in this population.

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Atrioventricular and intraventricular block after transcatheter aortic valve implantation

Cited by 8 publications

References 49 publications

Intraoperative Corticosteroids and Pacemaker Implantation After Transcatheter Aortic Valve Replacement

Intraoperative Corticosteroids and Pacemaker Implantation After Transcatheter Aortic Valve Replacement

Artificial Intelligence-Based Spiral CT 3D Reconstruction in Transcatheter Aortic Valve Implantation

Late onset complete heart block after transcatheter aortic valve replacement treated with permanent His‐bundle pacing

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