Bedside Electrophysiological Study Using a Temporary Pacemaker May Predict Recurrence of Atrioventricular Block After Transcatheter Aortic Valve Replacement.
High-degree atrioventricular block (HAVB) or complete heart block (CHB) is a common complication associated with transcatheter aortic valve replacement (TAVR). However, some patients with HAVB/CHB recover with time. The results of electrophysiological studies (EPSs) using permanent pacemaker implantation (PPI) in patients with suspicious HAVB/CHB are considered controversial.This study aimed to evaluate whether HAVB/CHB induction at the bedside using a temporary pacemaker can predict recurrence in patients who had recovered from HAVB/CHB after TAVR.We enrolled a total of 11 patients who had recovered from HAVB/CHB and evaluated their electrophysiology using right ventricular pacing and/or procainamide administration.HAVB/CHB induction was positive. Three patients tested positive for HAVB/CHB, whereas 8 tested negative. The ejection fraction and the interval between HAVB/CHB onset and EPS were found to be significant. HAVB/CHB positive patients underwent PPI. A patient with a balloon-expandable valve tested positive just before recovery of CHB, but tested negative 5 days later and was included in the negative group. The 4 patients who tested negative received a cardiovascular implantable electric device (CIED). We observed HAVB/CHB in 2 patients who had previously tested positive after 3 months. Among those who tested negative, those with CIED had no HAVB/CHB, and others showed neither HAVB/CHB on electrocardiogram nor experienced syncope or sudden death.Our EPS revealed that HAVB/CHB induction may predict HAVB/CHB recurrence after TAVR. Valve type and EPS timing may affect the results.
['Nauchi|Masahiro|M|', 'Yamawaki|Masahiro|M|', 'Nakano|Takahide|T|', 'Makino|Kenji|K|', 'Honda|Yosuke|Y|', 'Sakai|Tsuyoshi|T|', 'Ito|Yoshiaki|Y|']
D061605:Administration, Intravenous D000368:Aged D000369:Aged, 80 and over D000889:Anti-Arrhythmia Agents D001024:Aortic Valve Stenosis D054537:Atrioventricular Block D002037:Bundle-Branch Block D054849:Cardiac Electrophysiology D004562:Electrocardiography D005260:Female D006350:Heart Valve Prosthesis D006801:Humans D008297:Male D010138:Pacemaker, Artificial D000067716:Point-of-Care Testing D011237:Predictive Value of Tests D011342:Procainamide D012008:Recurrence D012189:Retrospective Studies D065467:Transcatheter Aortic Valve Replacement D016896:Treatment Outcome
Permanent pacemaker Aortic stenosis