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Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation
Permanent pacemaker implantation (PPI) represents a frequent complication after transcatheter aortic valve implantation (TAVI) due to atrio-ventricular (AV) node injury. Predictors of early AV function recovery were investigated. We analyzed 50 consecutive patients (82 ± 6 years, 58% males, EuroSCOR...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604573/ https://www.ncbi.nlm.nih.gov/pubmed/36286276 http://dx.doi.org/10.3390/jcdd9100324 |
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author | Pinnacchio, Gaetano Ruscio, Eleonora Rocco, Erica Trani, Carlo Burzotta, Francesco Aurigemma, Cristina Romagnoli, Enrico Scacciavillani, Roberto Narducci, Maria Lucia Bencardino, Gianluigi Perna, Francesco Spera, Francesco Raffaele Comerci, Gianluca Bisignani, Antonio Pelargonio, Gemma |
author_facet | Pinnacchio, Gaetano Ruscio, Eleonora Rocco, Erica Trani, Carlo Burzotta, Francesco Aurigemma, Cristina Romagnoli, Enrico Scacciavillani, Roberto Narducci, Maria Lucia Bencardino, Gianluigi Perna, Francesco Spera, Francesco Raffaele Comerci, Gianluca Bisignani, Antonio Pelargonio, Gemma |
author_sort | Pinnacchio, Gaetano |
collection | PubMed |
description | Permanent pacemaker implantation (PPI) represents a frequent complication after transcatheter aortic valve implantation (TAVI) due to atrio-ventricular (AV) node injury. Predictors of early AV function recovery were investigated. We analyzed 50 consecutive patients (82 ± 6 years, 58% males, EuroSCORE: 7.8 ± 3.3%, STS mortality score: 5 ± 2.8%). Pacemaker interrogations within 4–6 weeks from PPI were performed to collect data on AV conduction. The most common indication of PPI was persistent third-degree (44%)/high-degree (20%) AV block/atrial fibrillation (AF) with slow ventricular conduction (16%) after TAVI. At follow-up, 13 patients (26%) recovered AV conduction (i.e., sinus rhythm with stable 1:1 AV conduction/AF with a mean ventricular response >50 bpm, associated with a long-term ventricular pacing percentage < 5%). At multivariate analysis, complete atrio-ventricular block independently predicted pacemaker dependency at follow-up (p = 0.019). Patients with persistent AV dysfunction showed a significant AV conduction time prolongation after TAVI (PR interval from 207 ± 50 to 230 ± 51, p = 0.02; QRS interval from 124 ± 23 to 147 ± 16, p < 0.01) compared to patients with recovery, in whom AV conduction parameters remained unchanged. Several patients receiving PPI after TAVI have recovery of AV conduction within a few weeks. Longer observation periods prior to PPI might be justified, and algorithms to minimize ventricular pacing should be utilized whenever possible. |
format | Online Article Text |
id | pubmed-9604573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96045732022-10-27 Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation Pinnacchio, Gaetano Ruscio, Eleonora Rocco, Erica Trani, Carlo Burzotta, Francesco Aurigemma, Cristina Romagnoli, Enrico Scacciavillani, Roberto Narducci, Maria Lucia Bencardino, Gianluigi Perna, Francesco Spera, Francesco Raffaele Comerci, Gianluca Bisignani, Antonio Pelargonio, Gemma J Cardiovasc Dev Dis Article Permanent pacemaker implantation (PPI) represents a frequent complication after transcatheter aortic valve implantation (TAVI) due to atrio-ventricular (AV) node injury. Predictors of early AV function recovery were investigated. We analyzed 50 consecutive patients (82 ± 6 years, 58% males, EuroSCORE: 7.8 ± 3.3%, STS mortality score: 5 ± 2.8%). Pacemaker interrogations within 4–6 weeks from PPI were performed to collect data on AV conduction. The most common indication of PPI was persistent third-degree (44%)/high-degree (20%) AV block/atrial fibrillation (AF) with slow ventricular conduction (16%) after TAVI. At follow-up, 13 patients (26%) recovered AV conduction (i.e., sinus rhythm with stable 1:1 AV conduction/AF with a mean ventricular response >50 bpm, associated with a long-term ventricular pacing percentage < 5%). At multivariate analysis, complete atrio-ventricular block independently predicted pacemaker dependency at follow-up (p = 0.019). Patients with persistent AV dysfunction showed a significant AV conduction time prolongation after TAVI (PR interval from 207 ± 50 to 230 ± 51, p = 0.02; QRS interval from 124 ± 23 to 147 ± 16, p < 0.01) compared to patients with recovery, in whom AV conduction parameters remained unchanged. Several patients receiving PPI after TAVI have recovery of AV conduction within a few weeks. Longer observation periods prior to PPI might be justified, and algorithms to minimize ventricular pacing should be utilized whenever possible. MDPI 2022-09-24 /pmc/articles/PMC9604573/ /pubmed/36286276 http://dx.doi.org/10.3390/jcdd9100324 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Pinnacchio, Gaetano Ruscio, Eleonora Rocco, Erica Trani, Carlo Burzotta, Francesco Aurigemma, Cristina Romagnoli, Enrico Scacciavillani, Roberto Narducci, Maria Lucia Bencardino, Gianluigi Perna, Francesco Spera, Francesco Raffaele Comerci, Gianluca Bisignani, Antonio Pelargonio, Gemma Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title | Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title_full | Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title_fullStr | Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title_full_unstemmed | Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title_short | Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation |
title_sort | short-term atrioventricular dysfunction recovery after post-tavi pacemaker implantation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604573/ https://www.ncbi.nlm.nih.gov/pubmed/36286276 http://dx.doi.org/10.3390/jcdd9100324 |
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