Post-Transcatheter Aortic Valve Implantation (TAVI) Heart Block in the Self-Expandable and Balloon Expandable Valves

One-year follow-up of conduction disturbances following transcatheter aortic valve implantation

“…[13][14][15][16][17][18][19][20][21] Moreover, the finding that first grade AVB and QRS width increased more in patients approached by CV confirms previous reports that the self-expandable characteristic of this prosthesis may have a greater effect on the nearby electrical structures. 9,13,16,17,18 Compared to its own baseline the ES-TA surprisingly reported higher rate of post-procedural LBBB compared to the other two groups. Probably the more accurate deployment of the prosthesis affected the atrio-ventricular conduction as a consequence of a major pressure applied on the conducting tissues.…”

“…1,2 Following TAVI, electrical conduction abnormalities are known to occur, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] leading to the placement of a permanent pacemaker (PM) in 5-46% of cases [17][18][19][20][21] .…”

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In this study, patients undergoing TAVI suffered a significant increase in atrio-ventricular (PQ interval) and intra-ventricular (QRS width) conduction times. Patients who were implanted with a CV prosthesis have the highest incidence of first-degree AVB and LBBB.…”

Transcatheter aortic valve replacement

“…9,10,63 There is clear evidence that the risk of heart block that requires a permanent pacemaker is higher after CoreValve implantation, which might be due to the extended frame expanding into the left-ventricular outflow tract. 1,10,[63][64][65][66] Several studies have further suggested that paravalvular and central regurgitation might be more common after CoreValve implantation, 9,10,63 while others have been unable to demonstrate significant differences. 64 Some studies support that the SAPIEN valve might be associated with higher gradients and lower orifice areas, and that this valve might carry a higher risk of coronary artery obstruction.…”

“…40 The most common indication is occurrence of AV block. 66 Nuis et al reported that the overall prevalence of conduction abnormalities after CoreValve implantation is as high as 82, with left-bundle branch block being the most frequent. 87 In most cases, the conduction abnormality occurs during the procedure itself or within 24 hours, but cases of delayed heart block after up to 30 days have been described.…”