What is the incidence of early conduction disorders and the need for permanent pacemaker implantation following percutaneous aortic valve replacement in patients with severe aortic stenosis?
Percutaneous aortic valve replacement is associated with a high incidence of early postoperative conduction disorders (68%) and a significant need for permanent pacemaker implantation (20%).
BACKGROUND: Percutaneous aortic valve replacement (PAVR) may be an alternative therapy for patients with severe aortic stenosis who are denied valve surgery because of age and comorbidity. Data are few regarding the incidence of early conduction disorders (CD) after PAVR. We examined the incidence and characteristics of CD in the immediate postoperative period after PAVR, and the need for permanent pacemaker (PPM) implantation. METHODS AND RESULTS: Between June 2007 and June 2008 30 patients (mean age = 82.1 +/- 8.5 years) underwent PAVR in our institution. The incidence of new, postoperative CD, diagnosed by 12-lead or 24-hour Holter electrocardiogram, was 68.0%. Left bundle branch block was the most common conduction abnormality, with an incidence of 45.8%. The incidence of complete atrioventricular block requiring PPM implantation was 20%. CONCLUSIONS: We observed a higher incidence of early conduction disorders and need for PPM implantation after PAVR than generally reported after surgery. Whether this observation is clinically important requires larger prospective studies and follow up.
Calvi et al. (Mon,) studied this question.