Key result
Percutaneous structural heart interventions carry up to ~70% risk of new conduction disturbances, worsening prognosis.
Why the study?
New onset conduction disturbances occur frequently after percutaneous structural heart disease interventions and are influenced by the anatomical proximity of the conduction system to the repair site, but strategies to reduce this complication require further elucidation.
This review highlights the anatomical proximity of the conduction system to structural heart disease intervention sites and discusses strategies to mitigate the 5-70% risk of new onset conduction disturbances.
Answers are grounded in this paper and cite their sources.
Heightened monitoring for conduction issues is prudent after structural interventions; leaves open optimal mitigation strategies.
Transcatheter procedures offer an alternative to cardiac surgery in select patients with structural heart disease (SHD). Unfortunately, inadvertent disruption of electrical pathways and subsequent development of new onset conduction disturbances can occur in up to 5–70% of percutaneous interventions, result in pacemaker implantation, and confer a worse prognosis. The physical proximity between the conduction system (atrioventricular node, bundle of His, and bundle branches) and the site of percutaneous repair is increasingly recognized as a key factor influencing new onset conduction disturbance development in procedures located near the conduction system. This review covers the incidence, clinical significance, and mechanisms of new onset conduction disturbances and discusses current and emerging strategies to address this complication in these populations.
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Albaghdadi et al. (2021) conducted a review in Structural heart disease. Percutaneous structural heart disease interventions was evaluated on New onset conduction disturbances. New onset conduction disturbances occur in up to 5–70% of percutaneous structural heart disease interventions, often resulting in pacemaker implantation and conferring a worse prognosis.
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