Calcium distribution patterns of the aortic valve as a risk factor for the need of permanent pacemaker implantation after transcatheter aortic valve implantation

Fujita, Buntaro; Kütting, Maximilian; Seiffert, Moritz; Scholtz, Smita; Egron, Sandrine; Prashovikj, E.; Börgermann, Jochen; Schäfer, T; Scholtz, Werner; Preuss, R.; Gummert, Jan; Steinseifer, Ulrich; Ensminger, Stephan

doi:10.1093/ehjci/jev343

Cited by 130 publications

(65 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, in TAVI patients, a transient and wide range of damage is applied to the conduction pathway at the time of implantation. The degree of AVCD is influenced by many mechanisms such as deep insertion of the device , calcified valves , and wire injury in TAVI patients. Although the restoration rate of AVCD depends on how much the conduction pathway is damaged, it is difficult to predict the degree of AVCD because of the multifactorial cause of AVCD.…”

Section: Discussionmentioning

confidence: 99%

Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation

Takahashi¹,

Badenco

Monteau³

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation

Takahashi¹,

Badenco

Monteau³

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Although many studies have reported RBBB prior to TAVR as being a strong predictive factor for need for PPI after the procedure, there is sparse information on RBBBs that develop after TAVR . Our data indicate that a patient who develops new RBBB will be more likely to progress to CHB and need a pacemaker than a patient who does not develop a new RBBB (P < 0.0001) (Table ).…”

Section: Discussionmentioning

confidence: 66%

“…Additionally, patients suffering from chronic kidney disease who undergo TAVR are more likely to develop new conduction abnormalities requiring a pacemaker . Although our study did not examine baseline conduction abnormalities, numerous studies have found a strong association between baseline RBBB and need for PPI after TAVR . Lastly, a lower implantation depth of the prosthesis has been found to be a predictive factor for PPI as well …”

Section: Discussionmentioning

confidence: 76%

“…Aortic valve calcification has been shown to be an independent predictor of poor outcome for patients suffering from severe aortic stenosis . Aortic valve calcification has also shown to be an independent predictor of need for PPI after TAVR, but not all studies have reached this conclusion . Additionally, patients suffering from chronic kidney disease who undergo TAVR are more likely to develop new conduction abnormalities requiring a pacemaker .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac conduction abnormalities associated with pacemaker implantation after transcatheter aortic valve replacement

Cresse

Eisenberg

Alfonso

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background: Complete heart block is a known complication after transcatheter aortic valve replacement (TAVR), often requiring pacemaker implantation within 24 hours of the procedure.However, clinical markers for delayed progression to complete heart block after TAVR remain unclear. Objectives:We examined electrocardiographic data that may correlate with delayed progression to complete heart block and need for pacemaker.Methods: This is a single-center retrospective study of 608 patients who underwent TAVR between April 2008 and June 2017. We excluded 164 (27.0%) patients due to having a pacemaker before the procedure or expiring within 24 hours of the procedure (8, 1.3%). We excluded an additional 50 (8.2%) patients who received a pacemaker within 24 hours of the procedure. Electrocardiograms (EKGs) obtained after the procedure were compared to the preprocedural EKG to detect new changes.Results: Left bundle branch block, intraventricular conduction delay, left anterior fascicular block, and right bundle branch block were the most commonly seen conduction abnormalities after TAVR (25.1%, 10.9%, 7.5%, and 3.6%, respectively). Both left bundle branch block (odds ratio [OR] = 2.77 [95% confidence interval (CI): 1.24-6.22]) and right bundle branch block (OR = 13.2 [95% CI: 4.18-41.70]) carried an increased risk of pacemaker implantation after TAVR. Additionally, ΔPR greater than 40 ms from baseline also carried an increased risk of pacemaker implantation (OR = 3.53 [95% CI: 1.49-8.37]). Conclusion:Left bundle branch block, right bundle branch block, and ΔPR greater than 40 ms were all associated with delayed progression to complete heart block and need for pacemaker implantation after TAVR. K E Y W O R D SEKG, pacemaker implantation, transcatheter aortic valve replacement 846

show abstract

“…8,33,35,36 The presence and distribution of calcification underneath the aortic annulus plane and affecting the interventricular septum are 9 anatomical factors associated with the need for PPM implantation. 8,33,37,38 As discussed previously, implantation depth into the left ventricular outflow tract is also strongly associated with increased risk of PPM implantation after TAVR, regardless of valve type. 39 The impact of new PPM implantation after TAVR on the long-term outcomes has been controversial in recent years.…”

Section: Discussionmentioning

confidence: 71%

Impact of postprocedural permanent pacemaker implantation on clinical outcomes after transcatheter aortic valve replacement: A systematic review and meta-analysis

Liu

Liang

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The incidence of conduction disturbances requiring permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) have remained a common concern. The purpose of this study was to evaluate the impact of postprocedural PPM implantation following TAVR on clinical outcomes. Methods: We performed a systematic search in PubMed and EMBASE databases for studies that reported raw data on clinical outcomes of patients with and without PPM implantation after TAVR and followed up patients for 10 months or longer. The primary endpoint was all-cause death. The secondary endpoints were cardiovascular death, heart failure and a composite of stroke and myocardial infarction (MI). Results: Data from 20 studies with a total of 21666 patients undergoing TAVR, of whom 12.5% required PPM implantation after intervention, were analysed and the mean duration follow-up was 16.9 months. The rate of PPM ranged from 6.2% to 32.8% among different studies. A total of 6753 (31.2%) patients underwent TAVR with self-expandable prosthesis and 14913 (68.8%) with balloon-expandable prosthesis. The incidence of postprocedural PPM implantation was higher with the self-expandable prosthesis (n=1717, 25.4%) compared with the balloon-expandable prosthesis (n=996, 6.7%). PPM after TAVR was associated with a higher risk of all-cause death (RR: 1.13; 95% CI: 1.01-1.25; P=0.03) but not incidence of stroke and MI (RR: 0.85; 95% CI: 0.64-1.13; P=0.27). Conclusions: In patients undergoing TAVR, the PPM implantation after intervention was associated higher all-cause mortality but not cardiovascular mortality, heart failure and stroke or MI, which remain an unsolved issue of TAVR.

show abstract

Calcium distribution patterns of the aortic valve as a risk factor for the need of permanent pacemaker implantation after transcatheter aortic valve implantation

Cited by 130 publications

References 23 publications

Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation

Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation

Cardiac conduction abnormalities associated with pacemaker implantation after transcatheter aortic valve replacement

Impact of postprocedural permanent pacemaker implantation on clinical outcomes after transcatheter aortic valve replacement: A systematic review and meta-analysis

Contact Info

Product

Resources

About