Key result
Non-continuous mobile ECG monitoring detects delayed conduction disturbances requiring pacing in ~8% of post-TAVR patients.
Why the study?
Permanent pacemaker implantation remains a key drawback of TAVR, and the optimal strategy for monitoring delayed conduction disturbances in these patients is unclear.
Does a 30-second spot ambulatory mobile electrocardiogram monitoring strategy effectively and safely detect delayed conduction disturbances requiring permanent pacemaker implantation in patients post-transcatheter aortic valve replacement?
Cohort (n=100)
No
Does a 30-second spot ambulatory mobile electrocardiogram monitoring strategy effectively and safely detect delayed conduction disturbances requiring permanent pacemaker implantation in patients post-transcatheter aortic valve replacement?
A remote, non-continuous 30-second digital ECG monitoring approach safely identifies delayed conduction disorders requiring pacing in TAVR outpatients and achieves exceptionally high compliance.
May support feasibility of spot mobile ECG post-TAVR; leaves open whether it improves outcomes versus standard monitoring.
AIMS: Permanent pacemaker implantation (PPM-I) remains nowadays the most important drawback of transcatheter aortic valve replacement (TAVR) procedure and the optimal strategy of delayed conduction disturbances (CDs) in these patients is unclear. The study aimed to validate an ambulatory electrocardiogram (ECG) monitoring through a 30 s spot ambulatory digital mobile ECG (AeECG), by using KardiaMobile-6L device in a 30-day period after TAVR procedure. METHODS AND RESULTS: Between March 2021 and February 2022, we consecutively enrolled all patients undergoing TAVR procedure, except pacemaker (PM) carriers. At discharge, all patients were provided of a KardiaMobile-6L device and a spot digital ECG (eECG) recording 1 month schedule. Clinical and follow-up data were collected, and eECG schedule compliance and recording quality were explored. Among 151 patients without pre-existing PM, 23 were excluded for pre-discharge PPM-I, 18 failed the KardiaMobile-6L training phase, and 10 refused the device. Delayed CDs with a Class I/IIa indication for PPM-I occurred in eight patients (median 6 days). Delayed PPM-I vs. non-delayed PPM-I patients were more likely to have longer PR and QRS intervals at discharge. PR interval at discharge was the only independent predictor for delayed PPM-I at multivariate analysis. The overall eECG schedule compliance was 96.5%. None clinical adverse events CDs related were documented using this new AeECG monitoring modality. CONCLUSION: A strategy of 30 s spot AeECG is safe and efficacious in delayed CDs monitoring after TAVR procedure with a very high eECG schedule level of compliance.
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Lucia et al. (2023) conducted a cohort in Delayed conduction disturbances after transcatheter aortic valve replacement (n=100). 30-second spot ambulatory digital mobile ECG monitoring (KardiaMobile-6L) was evaluated on Incidence of delayed conduction disturbances with a Class I or IIa indication for permanent pacemaker implantation. A non-continuous ambulatory mobile electrocardiogram monitoring strategy safely identified delayed conduction disturbances requiring permanent pacemaker implantation in 8% of post-TAVR patients, with a 96.5% schedule compliance rate.
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