Intraprocedural dynamics of cardiac conduction during transcatheter aortic valve implantation: Assessment by simultaneous electrophysiological testing

Reiter, Christian; Lambert, Thomas; Kellermair, Joerg; Blessberger, Hermann; Fellner, Alexander; Strasser, Bernhard; Grund, Michael; Nahler, Alexander; Steinwender, Clemens

doi:10.1016/j.hrthm.2020.10.018

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…Fifth, in patients with documented high degree AVB, an electrophysiologic study was not performed to precisely determine the site of AVB. However, although the AV node may be damaged after TAVR, 24 it is assumed that high degree AVB is usually located in the infranodal conduction system in these patients 25 …”

Section: Discussionmentioning

confidence: 99%

The QRS frontal plane axis changes during left bundle branch block after transcatheter aortic valve replacement

Yagel,

Belhassen,

Planer

et al. 2023

Pacing Clinical Electrophis

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Background and AimsLeft bundle branch block (LBBB) is common after transcatheter aortic valve replacement (TAVR) and associated with a left or normal QRS axis. We aim to assess the QRS frontal plane axis shift changes during LBBB after TAVR and determine if the risk of procedure‐related high degree atrioventricular block (AVB) is affected by QRS axis shift changes.Methods and ResultsIn a retrospective single‐center study of 720 consecutive patients who underwent TAVR, 141 (19.6%) with normal baseline QRS duration developed a new LBBB after TAVR and constituted the study group. Most patients (59.6%) were females and the mean age of the cohort was 81.2 ± 6 years.ResultsAs compared with the baseline QRS axis before TAVR, the occurrence of LBBB was associated with a leftward QRS axis shift (by 40 ± 28.3°) in 73% of the study patients and a rightward (by 18.6 ± 19.4°) or no change in QRS axis in 25.6% and 1.4% of the study patients, respectively. A left QRS axis (−30°) was observed in 14.9% and 38.3% of the study patients before and after TAVR, respectively. The group of patients exhibiting a rightward or no QRS axis shift had a greater incidence of high degree AVB than the group of patients exhibiting a leftward QRS axis shift (18.4% vs. 6.8%, p = .056).ConclusionAlthough post TAVR‐LBBB is associated with a leftward QRS axis shift in most patients, a non‐negligible proportion of patients (27%) exhibited a rightward or no QRS axis shift. The latter group tend to have a higher risk of developing high degree AVB.

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Section: Discussionmentioning

confidence: 99%

The QRS frontal plane axis changes during left bundle branch block after transcatheter aortic valve replacement

Yagel,

Belhassen,

Planer

et al. 2023

Pacing Clinical Electrophis

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show abstract

“…Although the association between low implantation depth and PMI rate after TAVR has been previously described, 18 Reiter et al 19 found no correlation between implantation depth and HV prolongation. Similarly, in our study, implantation depth did not differ between the group with prolonged HV interval and the group with normal HV interval intraprocedurally after TAVR.…”

Section: Discussionmentioning

confidence: 90%

Impact of implantation depth and calcium burden on infranodal conduction delay after transcatheter aortic valve replacement

Papa,

Serban,

Strebel

et al. 2024

Heart Rhythm O2

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“…The literature search identified 657 potentially eligible studies, of which 24 were further evaluated in full text. A total of 18 studies 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 with 1230 patients (mean 68 patients per study) reporting on nonoverlapping patient populations were considered eligible ( Supplemental Material Section 2 ). The characteristics of the included studies and patients are summarized in Tables 1 and 2 .…”

Section: Resultsmentioning

confidence: 99%

Invasive electrophysiological testing to predict and guide permanent pacemaker implantation after transcatheter aortic valve implantation: A meta-analysis

Siontis¹,

Balla²,

Cha³

et al. 2023

Heart Rhythm O2

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Intraprocedural dynamics of cardiac conduction during transcatheter aortic valve implantation: Assessment by simultaneous electrophysiological testing

Cited by 7 publications

References 32 publications

The QRS frontal plane axis changes during left bundle branch block after transcatheter aortic valve replacement

The QRS frontal plane axis changes during left bundle branch block after transcatheter aortic valve replacement

Impact of implantation depth and calcium burden on infranodal conduction delay after transcatheter aortic valve replacement

Invasive electrophysiological testing to predict and guide permanent pacemaker implantation after transcatheter aortic valve implantation: A meta-analysis

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