Conduction Disorders and Permanent Cardiac Pacemaker After Transcatheter Aortic Implantation - An Update Overview

Abstract

Aortic valve substitution is a standard technique with tolerable risk; nevertheless, the high mortality may be contraindicated. To reduce morbidity and mortality minimally invasive transcatheter aortic valve implantation (TAVI) may be an alternative approach. Although considered secure, after the method complications can occur, presenting as new-onset persistent left bundle branch block and demanding pacemaker implant. To establish how frequent this probability is, a systematic review from PUBMED (philters used were "15 years" and "free full texts") was achieved applying the terms "TAVI", "pacing" and "complications". For supporting literature, the other sources (SCIELO, Google Scholar and MEDLINE) were used and consulted for supporting literature. Catheter aortic prosthesis implantation is an effective modality for patients with high surgical risk and severe aortic stenosis. The review results suggest that the need for a pacemaker after endovascular treatment is neither inevitable nor easily predicted by known risk factors. Even though TAVI is considered a safe technique of selection, the implant position is near to functionally significant septal cardiac structures. Conduction disorders are frequent and need prudent checking after the procedure. Forthcoming studies must be necessary to validate the proposed algorithm and define the role of EP studies, ambulatory continuous electrocardiogram (Holter 24 hours) monitoring and preventive pacemaker in the management of conduction disturbances in patients undergoing transcatheter aortic valve replacement