Ambulatory Rhythm Monitoring to Detect Late High-Grade Atrioventricular Block Following Transcatheter Aortic Valve Replacement

Ream, Karen; Sandhu, Amneet; Valle, Javier A.; Weber, Rachel; Kaizer, Alexander; Wiktor, Dominik M.; Borne, Ryan T.; Tumolo, Alexis Z.; Kunkel, Megan; Zipse, Matthew M.; Schuller, Joseph L.; Tompkins, Christine; Rosenberg, Michael; Nguyen, Duy T.; Cleveland, Joseph C.; Fullerton, David A.; Carroll, John D.; Messenger, John C.; Sauer, William H.; Aleong, Ryan G.; Tzou, Wendy S.

doi:10.1016/j.jacc.2019.02.068

Cited by 76 publications

(60 citation statements)

References 23 publications

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“…In particular, this paper indings that over 4.0% of TAVR patients not receiving PPM during their index hospitalization underwent PPM procedures during the follow-up period. This inding supports concerns related to atrioventricular block following TAVR [18] and gives providers insight into potential bundling of devices from manufacturers to cover this additional cost. In addition, under bundled payments, it will be inancially advantageous to manage the comorbid conditions associated with readmissions.…”

Section: Discussionsupporting

confidence: 61%

Impact of Pacemaker Implantation on 12-Month Resource Utilization Following TAVR Hospitalization

Culler¹,

Kugelmass²,

Cohen³

et al. 2019

J Cardiol Cardiovasc Med

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Section: Discussionsupporting

confidence: 61%

Impact of Pacemaker Implantation on 12-Month Resource Utilization Following TAVR Hospitalization

Culler¹,

Kugelmass²,

Cohen³

et al. 2019

J Cardiol Cardiovasc Med

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“…Baseline ECG abnormalities such as first-degree AVB, left anterior hemiblock, and right bundle branch block as well as intraprocedural AVB are predictors for implantation of PM after TAVR. 7 , 8 …”

Section: Discussionmentioning

confidence: 99%

“… 11 Longer periods of monitoring could be useful in the post-TAVR setting. A recent publication by Ream et al., 8 using a 30-day loop monitoring device in 150 post-TAVI patients, demonstrated delayed AVB in 12 of them with a median of 6 days (range, 3-24 days). Also, in a more recent experience by Tian et al., 14 remote monitoring for 30 days after TAVR allowed detection of AVB that required a PM implant in an additional 8.6% of patients after discharge.…”

Section: Discussionmentioning

confidence: 99%

Remote Ambulatory Cardiac Monitoring Before and After Transcatheter Aortic Valve Replacement

et al. 2020

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Remote ambulatory cardiac monitoring (rACM) could identify high-grade atrioventricular block (AVB) before and after transcatheter aortic valve replacement (TAVR). Retrospective analysis of patients undergoing TAVR, with 14-day rACM before and after TAVR, was performed. Of 62 patients undergoing TAVR, 41 patients had rACM before TAVR. Three patients had asymptomatic AVB leading to planned pacemaker (PM) implant. After TAVR, 23 patients had rACM, with 1 patient requiring a PM implant for asymptomatic AVB. Five patients underwent unplanned PM after TAVR. Using rACM, almost half of PM implants in TAVR recipients were identified electively. High-grade AVB requiring PM was identified in nearly 10% of patients before TAVR.

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“…Although the majority of conduction defects occur within a few days from the procedure, 3,22 the risk of high degree AV block requiring PPM implantation has been reported to continue at least 30 days after TAVR 23 …”

Section: Discussionmentioning

confidence: 99%

Early and late pace‐maker implantation after transcatheter and surgical aortic valve replacement

Biancari

Pykäri

Savontaus

et al. 2020

Cathet Cardio Intervent

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Background Conduction defects requiring permanent pacemaker (PPM) implantation are frequent complications occurring after surgical (SAVR) and transcatheter aortic valve replacement (TAVR). Methods Patients who underwent TAVR or SAVR with a bioprosthesis from the nationwide FinnValve registry were the subjects of this study. Patients with prior PPM, who received a sutureless prosthesis, or required cardiac resynchronization therapy or implantable cardioverter defibrillator were excluded from this analysis. Results Four thousand and ten patients underwent SAVR and 1,897 underwent TAVR. TAVR had an increased risk of PPM implantation at 30‐day (10.1% vs. 3.5%, unadjusted OR 3.11, 95%CI 2.56–3.87) and 5‐year (15.7% vs. 8.6%, unadjusted SHR, 2.12, 95%CI 1.81–2.48) compared to SAVR. PPM implantation within 30 days from the index procedure did not increase the risk of 5‐year mortality after either SAVR or TAVR. Among 1,042 propensity score matched pairs, TAVR had an increased risk of PPM implantation at 30‐day (9.9% vs. 4.7%, p < .0001) and 5‐year (14.7% vs. 11.4%, p = .001), but late (>30 days) PPM implantation at 5‐year (4.7% vs. 6.9% SHR 0.72, 95%CI 0.47–1.10) was comparable to SAVR. The types of prosthesis had an impact on 30‐day PPM implantation after TAVR, but not on late (>30 days) PPM implantation. Conclusions Although the risk of 30‐day PPM implantation is higher after TAVR compared to SAVR, late (>30 days) PPM implantation was comparable with these treatment methods. PPM implantation within 30 days did not affect late survival.

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Ambulatory Rhythm Monitoring to Detect Late High-Grade Atrioventricular Block Following Transcatheter Aortic Valve Replacement

Cited by 76 publications

References 23 publications

Impact of Pacemaker Implantation on 12-Month Resource Utilization Following TAVR Hospitalization

Impact of Pacemaker Implantation on 12-Month Resource Utilization Following TAVR Hospitalization

Remote Ambulatory Cardiac Monitoring Before and After Transcatheter Aortic Valve Replacement

Early and late pace‐maker implantation after transcatheter and surgical aortic valve replacement

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