Key result
Concomitant electrophysiological study during TAVI demonstrated an increase in mean HV interval from 53.2 ms to 62.8 ms, identifying one patient requiring permanent pacemaker implantation.
Why the study?
Data on the impact of left bundle-branch block after TAVI are scarce, and concomitant electrophysiological study may allow early stratification of patients requiring permanent pacemaker implantation.
Does concomitant electrophysiological study during TAVI predict the risk of atrioventricular block in patients with severe aortic stenosis?
Observational (n=7)
No
Does concomitant electrophysiological study during TAVI predict the risk of atrioventricular block in patients with severe aortic stenosis?
Answers are grounded in this paper and cite their sources.
Concomitant electrophysiological study during TAVI is a viable strategy to early stratify patients at risk for high-degree atrioventricular block and the need for permanent pacemaker implantation.
Introduction: Data on the impact of left bundle-branch block after transcatheter aortic valve implantation (TAVI) are scarce, and treatment has been individualized. Based on this, the electrophysiological study (EPS) concomitant with TAVI may be a strategy for the early stratification of patients needing permanent pacemaker implantation (PPM). Objective: To describe the use of EPS in risk stratification of a definitive pacemaker in patients undergoing TAVI. Materials and methods: Data from seven patients with indications for TAVI due to critical aortic stenosis were retrospectively evaluated. The EPS was performed with a quadripolar diagnostic catheter in His bundle to measure the His-ventricle (HV) interval. Measurement of HV at 70 ms or above was used for discussion on PPM implant indication. Results: Four analyzed patients evolved with left bundle-branch block after TAVI. PPM implantation was indicated for one patient, and the surgery was performed uneventfully during the same hospital stay. Before TAVI, the HV interval ranged from 46 to 58 ms (mean = 53.2 ms), increasing to 52 to 84 ms (mean = 62.8 ms) immediately after valve intervention. Conclusion: The strategy of EPS during TAVI is viable to stratify patients early according to the risk of 2nd or 3rd-degree atrioventricular block, allowing adequate treatment.
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Demuner et al. (2023) conducted an observational in Severe aortic stenosis (n=7). Electrophysiological study (EPS) with HV measurement during TAVI was evaluated on His-ventricle (HV) interval measurement and need for permanent pacemaker implantation. Concomitant electrophysiological study during TAVI demonstrated an increase in mean HV interval from 53.2 ms to 62.8 ms, identifying one patient requiring permanent pacemaker implantation.
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