Impact of Right Ventricular Pacing in Patients Who Underwent Implantation of Permanent Pacemaker After Transcatheter Aortic Valve Implantation

Nadeem, Fahd; Tsushima, Takahiro; Ladas, Thomas P.; Thomas, Rahul; Patel, Sandeep M.; Saric, Petar; Patel, Toral; Lipinski, Jerry; Li, Jun; Costa, Marco A.; Simon, Daniel I.; Kalra, Ankur; Attizzani, Guillherme F.; Arruda, Maurício; Mackall, Judith A.; Thal, Sergio

doi:10.1016/j.amjcard.2018.07.046

Cited by 32 publications

(26 citation statements)

References 26 publications

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“…Table 1 shows the baseline characteristics of the included studies. The 36 studies included a total of 55,851 patients in the final analysis, from 2005 to 2018 [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. The mean age of the patients was 81.9 years, with a mean STS score of 8.3.…”

Section: Resultsmentioning

confidence: 99%

Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis

Ravaux

Mauro

Vernooy

et al. 2021

JCM

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Data regarding the impact of infra-Hisian conduction disturbances leading to permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) remain limited. The aim of this study was to determine the impact of right and/or left bundle branch block (RBBB/LBBB) on post-TAVI PPI. We performed a systematic literature review to identify studies reporting on RBBB and/or LBBB status and post-TAVI PPI. Study design, patient characteristics, and the presence of branch block were analyzed. Odds ratios (ORs) with 95% CI were extracted. The final analysis included 36 studies, reporting about 55,851 patients. Data on LBBB were extracted from 33 studies. Among 51,026 patients included, 5503 showed pre-implant LBBB (11.9% (10.4%–13.8%)). The influence of LBBB on post-TAVI PPI was not significant OR 1.1474 (0.9025; 1.4588), p = 0.2618. Data on RBBB were extracted from 28 studies. Among 46,663 patients included, 31,603 showed pre-implant RBBB (9.2% (7.3%–11.6%)). The influence of RBBB on post-TAVI PPI was significant OR 4.8581 (4.1571; 5.6775), p < 0.0001. From this meta-analysis, the presence of RBBB increased the risk for post-TAVI PPI, independent of age or LVEF, while this finding was not confirmed for patients experimenting with LBBB. This result emphasizes the need for pre-operative evaluation strategies in patient selection for TAVI.

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Section: Resultsmentioning

confidence: 99%

Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis

Ravaux

Mauro

Vernooy

et al. 2021

JCM

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“…RV apical pacing is the traditional treatment for patients complicated with AV conduction disturbances after PV surgery. However, long-term RV apical pacing may induce ventricular electrical and mechanical asynchrony and therefore increase the risk for heart failure and mortality rate, especially for these patients with AV conduction diseases after PV surgery who have a need for significant ventricular pacing ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Permanent Left Bundle Branch Pacing in Patients With Conduction Disorders Following Prosthetic Cardiac Valves

Wei

Liao

et al. 2021

Front. Cardiovasc. Med.

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Background: The feasibility and safety of left bundle branch pacing (LBBP) in patients with conduction diseases following prosthetic valves (PVs) have not been well described.Methods: Permanent LBBP was attempted in patients with PVs. Procedural success and intracardiac electrical measurements were recorded at implant. Pacing threshold, complications, and echocardiographic data were assessed at implant and follow-up visit.Results: Twenty-two consecutive patients with atrioventricular (AV) conduction disturbances (10 with AV nodal block and 12 with infranodal block) underwent LBBP. The PVs included aortic valve replacement (AVR) in six patients, mitral valve repair or replacement (MVR) with tricuspid valve ring (TVR) in four patients, AVR with TVR in one patient, AVR with MVR plus TVR in three patients, transcatheter aortic valve replacement (TAVR) in five patients, and MVR alone in three patients. LBBP succeeded in 20 of 22 (90.9%) patients. LBB potential was observed in 15 of 22 (68.2%) patients, including 10 of 15 (66.7%) patients with AVR/TAVR and five of seven (71.4%) patients without AVR/TAVR. AVR and TVR served as good anatomic landmarks for facilitating the LBBP. The final sites of LBBP were 17.9 ± 1.4 mm inferior to the AVR and 23.0 ± 3.2 mm distal and septal to the TVR. The paced QRS duration was 124.5 ± 13.8 ms, while the baseline QRS duration was 120.0 ± 32.5 ms (P = 0.346). Pacing threshold and R-wave amplitude at implant were 0.60 ± 0.16 V at 0.5 ms and 11.9 ± 5.5 mV and remained stable at the mean follow-up of 16.1 ± 10.8 months. No significant exacerbation of tricuspid valve regurgitation was observed compared to baseline.Conclusion: Permanent LBBP could be feasibly and safely obtained in the majority of patients with PVs. The location of the PV might serve as a landmark for guiding the final site of the LBBP. Stable pacing parameters were observed during the follow-up.

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“…RVP is the traditional treatment method for patients complicated with CAs after PVs implantation. However, long‐term RVP, especially in patients who have a pacing dependency >40%, may induce electrical and mechanical asynchrony and therefore increase the mortality rate and heart failure hospitalization rate 5,16 Thus, physiological pacing appears as a more favorable option for this specific patient population 17,18 …”

Section: Discussionmentioning

confidence: 99%

“…The incidences ranging from 5% to 30% in patients underwent transcatheter aortic valve replacement (TAVR), approximately 5% to 10% in patients received surgical aortic valve replacement (SAVR), about 27% in patients following surgical tricuspid valve replacement (TVR) and 4.5% to 10.5% in patients underwent mitral valve repairmen (MVr) or mitral valve replacement (MVR) 1‐4 . It is widely known that conduction abnormalities (CAs) and right ventricular pacing (RVP) subsequently to PV implantation may induce electrical asynchrony, cardiac contraction asynchrony, atrial fibrillation (AF), heart failure, and early or late all‐cause mortality during short‐term or long‐term observation 5,6 . Left bundle branch pacing (LBBP) is a promising physiological pacing modality which has been proved to maintain electrical and mechanical synchrony and translate better hemodynamic effect compared with traditional RVP during the acute period in previous studies 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Feasibility and stability of left bundle branch pacing in patients after prosthetic valve implantation

Guo

Xiao

et al. 2020

Clinical Cardiology

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Background: Left bundle branch pacing (LBBP) has emerged as a promising pacing modality for preventing pacing induced cardiomyopathy in patients complicated with conduction abnormalities (CAs) after prosthetic valve (PV) implantation. Objective: The present study aimed to evaluate the safety and feasibility of LBBP in this patient population. Methods: LBBP was attempted in 20 patients complicated with atrioventricular block after PV implantation. Surface, intracardiac electrical measurements, and echocardiographic data were documented. Lead parameters and complications were routinely tracked at implantation and each follow-up visit. Results: LBBP was successful in 90% (18/20) participants. The paced QRS duration and the stimulus to left ventricular activation time were 106.8 ± 6.8 ms and 65.5 ± 5.4 ms, respectively. Left bundle branch (LBB) potential was recorded in 61.1% (11/18) patients who succeeded in LBBP. During the procedure, the mean unipolar myocardium capture threshold was 0.51 ± 0.15 V@0.4 ms while the unipolar bundle capture threshold was 0.84 ± 0.51 V@0.4 ms. The mean fluoroscopic exposure time and the radiation dose were 13.0 ± 9.2 min and 81.7 ± 8.3 mGy, respectively. The average follow-up period was 10.4 ± 5.9 months (range 3-23 months). Pacing parameters remained stable and no significant lead-related complications occurred during the whole observation period. Conclusions: LBBP was safe and feasible in patients with PVs. Acceptable and stable pacing parameters could be expected during the procedure and the follow-ups. K E Y W O R D S left bundle branch pacing, permanent pacemaker implantation, physiological pacing, prosthetic valves 1 | INTRODUCTION Atrioventricular heart block is a common complication in patients received prosthetic valve (PV) implantation. The incidences ranging Jincun Guo and Linlin Li contributed equally to this work.

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Impact of Right Ventricular Pacing in Patients Who Underwent Implantation of Permanent Pacemaker After Transcatheter Aortic Valve Implantation

Cited by 32 publications

References 26 publications

Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis

Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis

Feasibility and Safety of Permanent Left Bundle Branch Pacing in Patients With Conduction Disorders Following Prosthetic Cardiac Valves

Feasibility and stability of left bundle branch pacing in patients after prosthetic valve implantation

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