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Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed?
AIM: We compared early postprocedural and midterm evolution of atrioventricular and intraventricular conduction disorders following implantation of the new generation Evolut R (ER) prosthesis in comparison with the previous generation CoreValve (CV) system using routinely recorded ECG up to 6-month...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888433/ https://www.ncbi.nlm.nih.gov/pubmed/29632681 http://dx.doi.org/10.1136/openhrt-2017-000770 |
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author | Perrin, Nils Perrin, Tilman Hachulla, Anne-Lise Frei, Angela Müller, Hajo Roffi, Marco Cikirikcioglu, Mustafa Ellenberger, Christoph Licker, Marc-Joseph Burri, Haran Noble, Stephane |
author_facet | Perrin, Nils Perrin, Tilman Hachulla, Anne-Lise Frei, Angela Müller, Hajo Roffi, Marco Cikirikcioglu, Mustafa Ellenberger, Christoph Licker, Marc-Joseph Burri, Haran Noble, Stephane |
author_sort | Perrin, Nils |
collection | PubMed |
description | AIM: We compared early postprocedural and midterm evolution of atrioventricular and intraventricular conduction disorders following implantation of the new generation Evolut R (ER) prosthesis in comparison with the previous generation CoreValve (CV) system using routinely recorded ECG up to 6-month follow-up. METHODS: All consecutive patients treated by transcathether aortic valve implantation (TAVI) using the Medtronic self-expanding devices for symptomatic severe aortic stenosis in a single centre between October 2011 and February 2016 were considered for inclusion. ECGs recorded at baseline, day 1 after TAVI, discharge and 6 months were retrospectively analysed. At each time-point, intrinsic rhythm, PR interval, QRS axis and duration, and atrioventricular and intraventricular conduction were analysed. Atrioventricular and intraventricular conduction following TAVI at discharge and at 6 months were compared intrasubject at the different time intervals and between patients receiving the ER versus the CV prosthesis. RESULTS: Among the 113 patients included in the analysis (51% female, 83.3±6.2 years), 60 (53%) patients received the CV and 53 (47%) patients received the ER. Compared with patients in the CV group, those in the ER group had a lower Society of Thoracic Surgeons score (6.3±3.1vs 4.8±3.6, P=0.02). Patients in the ER group in comparison with those in the CV group more frequently had postprocedural PR interval (57%vs23%, respectively, P=0.004) and QRS prolongation (76%vs50%, P=0.03) at discharge. Incidence of complete atrioventricular block was similar between both groups (9%vs18%, P=0.3) up to 6-month follow-up. No difference in term of new left bundle branch block (LBBB) (34%vs28%, P=0.8) or permanent pacemaker implantation rates (32.1%vs31.7%, P=1.0) was reported. CONCLUSIONS: Patients with the ER had greater postprocedural atrioventricular and intraventricular conduction delays than those with the CV at discharge, with however similar incidence of high-degree atrioventricular block, new LBBB and permanent pacemaker implantation up to 6-month follow-up. |
format | Online Article Text |
id | pubmed-5888433 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-58884332018-04-09 Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? Perrin, Nils Perrin, Tilman Hachulla, Anne-Lise Frei, Angela Müller, Hajo Roffi, Marco Cikirikcioglu, Mustafa Ellenberger, Christoph Licker, Marc-Joseph Burri, Haran Noble, Stephane Open Heart Valvular Heart Disease AIM: We compared early postprocedural and midterm evolution of atrioventricular and intraventricular conduction disorders following implantation of the new generation Evolut R (ER) prosthesis in comparison with the previous generation CoreValve (CV) system using routinely recorded ECG up to 6-month follow-up. METHODS: All consecutive patients treated by transcathether aortic valve implantation (TAVI) using the Medtronic self-expanding devices for symptomatic severe aortic stenosis in a single centre between October 2011 and February 2016 were considered for inclusion. ECGs recorded at baseline, day 1 after TAVI, discharge and 6 months were retrospectively analysed. At each time-point, intrinsic rhythm, PR interval, QRS axis and duration, and atrioventricular and intraventricular conduction were analysed. Atrioventricular and intraventricular conduction following TAVI at discharge and at 6 months were compared intrasubject at the different time intervals and between patients receiving the ER versus the CV prosthesis. RESULTS: Among the 113 patients included in the analysis (51% female, 83.3±6.2 years), 60 (53%) patients received the CV and 53 (47%) patients received the ER. Compared with patients in the CV group, those in the ER group had a lower Society of Thoracic Surgeons score (6.3±3.1vs 4.8±3.6, P=0.02). Patients in the ER group in comparison with those in the CV group more frequently had postprocedural PR interval (57%vs23%, respectively, P=0.004) and QRS prolongation (76%vs50%, P=0.03) at discharge. Incidence of complete atrioventricular block was similar between both groups (9%vs18%, P=0.3) up to 6-month follow-up. No difference in term of new left bundle branch block (LBBB) (34%vs28%, P=0.8) or permanent pacemaker implantation rates (32.1%vs31.7%, P=1.0) was reported. CONCLUSIONS: Patients with the ER had greater postprocedural atrioventricular and intraventricular conduction delays than those with the CV at discharge, with however similar incidence of high-degree atrioventricular block, new LBBB and permanent pacemaker implantation up to 6-month follow-up. BMJ Publishing Group 2018-03-25 /pmc/articles/PMC5888433/ /pubmed/29632681 http://dx.doi.org/10.1136/openhrt-2017-000770 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Valvular Heart Disease Perrin, Nils Perrin, Tilman Hachulla, Anne-Lise Frei, Angela Müller, Hajo Roffi, Marco Cikirikcioglu, Mustafa Ellenberger, Christoph Licker, Marc-Joseph Burri, Haran Noble, Stephane Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title | Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title_full | Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title_fullStr | Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title_full_unstemmed | Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title_short | Conduction disorders using the Evolut R prosthesis compared with the CoreValve: has anything changed? |
title_sort | conduction disorders using the evolut r prosthesis compared with the corevalve: has anything changed? |
topic | Valvular Heart Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888433/ https://www.ncbi.nlm.nih.gov/pubmed/29632681 http://dx.doi.org/10.1136/openhrt-2017-000770 |
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