Short-term pacemaker dependency after transcatheter XXXX .

@entity1 @entity1165 @entity714 @entity713 @entity886 @entity1817 @entity5036 @entity955 @entity472
BACKGROUND: Transcatheter @entity886 (TAVI) is a less invasive technique for the treatment of severe @entity472 in high-risk @entity1 . Occurrence of conduction disturbances requiring permanent pacemaker (PPM) implantation after TAVI is frequently observed. METHODS: The retrospective analysis comprised 153 @entity1 (96 @entity1 , aged from 65 to 97 years) who underwent TAVI due to high-grade @entity472 . The aim was to evaluate the incidence of high-grade atrioventricular (AV) block after TAVI and the percentage of ventricular pacing and pacemaker (PM)-dependency at the first follow-up 6-8 weeks after implantation. RESULTS: Out of the 153 @entity1 (age 81        6 years) who underwent TAVI, 144 (94   %) had a transfemoral and 9 (6   %) @entity1 a transapical approach. A PPM was implanted in 31 (20   %) @entity1 , 24 (16   %) were implanted with the Medtronic CoreValve   and 7 (5   %) with the Edwards Sapien   valve (p   =   n.s.). Complete @entity713 was the indication in 21 @entity1 (68   %), second-degree @entity713 in 1 @entity1 (3   %), slow @entity955 in 3 @entity1 (10   %), new @entity714 ( @entity714 ) plus sustained @entity1165 ( @entity1165 ) in 1 @entity1 (3   %), @entity1817 in 2 @entity1 (7   %), whereas in 3 @entity1 (10   %) a PPM was inserted for safety reasons because of new @entity714 and first-grade @entity713 . All of the nine @entity1 (6   %) with a preexisting bundle @entity5036 developed total @entity713 after TAVI. At follow-up PM-dependency (intrinsic rhythm <   30  bpm) occurred in 11/30 @entity1 (37   %), whereas an intrinsic rhythm >   50  bpm was seen in 17 @entity1 (57   %). At nominal device programming the percentage of ventricular stimulation (VP) during the short-term observation period was 60        44   % in dual-chamber devices (N   =   18), and 70        36   % in single-chamber PPM (N   =   5). CONCLUSION: The PPM implantation rate of about 20   % after TAVI is comparable to previously published data. The need for permanent pacing is linked to the valve type and preexistence of a @entity714 . At short-term more than half of the @entity1 implanted with a device were not strictly PM-dependent, but presented an underlying intrinsic rhythm, indicating that temporary AV conduction disturbances may recover over time. This might justify a more conservative approach in some @entity1 under watchful waiting. From another point of view, ventricular pacing at a regular or sensor-modulated rate may provide rhythm stability and chronotropy during the short-term period post-TAVI.
