期刊
REVISTA ESPANOLA DE CARDIOLOGIA
卷 71, 期 3, 页码 162-169出版社
EDICIONES DOYMA S A
DOI: 10.1016/j.recesp.2017.03.032
关键词
Aortic stenosis; Transcatheter aortic valve implantation; Left bundle branch block; Pacemaker; Conduction disturbances; Conduction abnormalities; Direct transcatheter aortic valve implantation; Balloon aortic valvuloplasty
Introduction and objectives: Little is known about the timing of Onset and outcome of conduction abnormalities (CA) following balloon-expandable transcatheter aortic valve implantation. The aim of this study was to examine the timing of CA and determine the impact of balloon aortic valvuloplasty (BAV) on the persistence of these abnormalities. Methods: A total of 347 patients were included. Of these, 75 had a continuous electrocardiogram recording and a 6-lead electrocardiogram at each step of the procedure. Results: In the transcatheter aortic valve implantation population undergoing continuous electrocardiogram monitoring, new-onset left bundle branch block (LBBB) or third-degree atrioventricular block occurred in 48 (64%) and 16 (21.3%) patients, with 51.5% of CA occurring before valve implantation. Left bundle branch block persisted more frequently at hospital discharge (53.8 vs 22.7%; P = .028) and at 1-month follow-up (38.5 vs 13.6%; P = .054) when occurring before valve implantation. Balloon aortic valvuloplasty prior to valve implantation was used in 264 (76.1%) patients, and 78 (22.5%) had persistent LBBB or complete atrioventricular block requiring pacemaker implantation. Persistent LBBB or unresolved atrioventricular block at 1 month occurred more frequently in the BAV group (76.1 vs 47.6%; P = .021), and the use of BAV was associated with a lack of CA resolution (OR, 3.5; 95%Cl, 1.17-10.43; P = .021). Conclusions: In patients undergoing a balloon-expandable transcatheter aortic valve implantation, more than half of CA occurred before valve implantation. Early occurrence of CA was associated with a higher rate of persistence at 1-month follow-up. The use of BAV was associated with an increased risk of CA persistence. (C) 2017 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据