Hisian Lead Electrical Decay After TAVR Intervention

Figures

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  Figure 1. Pre–Transcatheter Aortic Valve Replacement Computed Tomography (A) Axial view of the aortic valve virtual basal ring (VBR). The Hisian lead can be observed already at this level between the right and noncoronary cusps. (B) The long axis of the left ventricular outflow tract at the level of contact of the pacemaker into the septum. The pink line is the aortic valve VBR. The distance between the VBR and the pacemaker is 1.8 mm (yellow line).

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  Figure 2. 3 Cusp View Comparison between (A) pre-TAVR computed tomography and (B) the same projection at 3-cusp intraprocedural fluoroscopy.

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  Figure 3. Hisian Lead and THV Relationships Fluoroscopic anteroposterior views after transcatheter aortic valve replacement. (A) The transcatheter heart valve stent extends below the pacemaker lead. (B) After extraction of the pacemaker, the near lead is implanted far distally in the septum well below the transcatheter heart valve.

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  Figure 4. Hisian Lead and Electrical Conduction System Drawing representation of the contact between the transcatheter aortic valve replacement valve, His lead (blue), and electrical conduction (red).

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  Figure 5. ECG Pre- and Post-PM Replacement (A) Electrocardiogram pre–pacemaker replacement. (B) Electrocardiogram post–pacemaker replacement.

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  Figure 6. Final Thoracic X-Ray (A) Thoracic x-ray film before discharge in anteroposterior view. (B) X-ray film in lateral view.