Conduction abnormalities and permanent cardiac pacing after transcatheter aortic valve implantation

Introduction: T he transcatheter aortic valve implan-tation procedure (TAVI) is frequently associated with atrioventricular and/or intraventricular conduction defects often requiring cardiac pacemaker implantati-on.

Scope: Evaluating cardiac conduction defects and the need for pacemaker implantation in patients who un-derwent a TAVI procedure.

Method: There were 199 TAVI procedures from 2015 until present at the Emergency Institute for Cardiovas-cular Diseases „Prof. Dr. C.C. Iliescu”, Bucharest. We performed a retrospective analysis of clinical and pa-raclinical data of these patients, with selection of pati-ents who developed cardiac conduction defects and in whom a pacemaker was implanted, excluding patients with preprocedural pacemaker.

Results: After analysis of the 199 patients, we found 10 patients with preprocedural pacemakers, 41 patients (21.6%) developed new cardiac conduction defects or had aggravated preprocedural conduction defects: of these 16 patients (39%) had LBBB, 11 patients (26.8%) first degree AVB, 15 patients (36.5%) type 2 second de-gree AVB and 9 patients (21,9%) third degree AVB. Of these, in 14 patients (34%) there was a pacemaker im-planted, most of them early after TAVI (11 patients). Most of the conduction defects developed in the first 24 hours after TAVI (23 patients), and the rest develo-ped 24-72 hours post-TAVI (11 patients) or during the intervention (7 patients). The mean time for the pace-maker implantation was 3,6 days.

Conclusions: Most of the conduction defects develo-ped in the first 24 hours post-TAVI. A significant pro-portion of the patients who developed cardiac conduc-tion defects after TAVI required permanent pacing.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)