Valvular heart diseasePredictors and Course of High-Degree Atrioventricular Block After Transcatheter Aortic Valve Implantation Using the CoreValve Revalving system
Section snippets
Methods
The study population included consecutive patients with aortic stenosis in whom a CoreValve Revalving System was implanted at 3 referral medical centers in Israel from 2008 to 2010. The patients were referred for TAVI after a careful evaluation and discussion by a local heart team, with a consensus that surgical aortic valve replacement would be associated with either high or prohibitive risk. The baseline clinical, electrocardiographic, echocardiographic, and angiographic parameters were
Results
Of the 70 study patients, 25 (36%) developed HDAVB during or after the procedure. All patients who developed HDAVB underwent PPM implantation. In addition, 3 patients underwent PPM implantation because of the development of left bundle branch block with PR prolongation (n = 2) or slow atrial fibrillation (n = 1). Thus, 28 patients (40%) required PPM implantation after the procedure. The baseline clinical, electrocardiographic, echocardiographic, and procedural characteristics, stratified by the
Discussion
The results of the present study have confirmed previous data regarding the relatively high rate of the development of major AV conduction abnormalities followed by PPM implantation among patients who undergo TAVI using the CoreValve system. We have shown that HDAVB developed in 35% of study patients, and the need for PPM implantation developed in 40% of study patients within 30 days of the procedure. Furthermore, in most patients who developed HDAVB (96%), it occurred within the first 5 days
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