The effects of transcatheter aortic valve implantation on cardiac electrical properties

• Type: Article in National Scientific Journal
• Date: 2020

Authors

Manuel, AM (Author) Other; Almeida, J (Author) Other; Guerreiro, C (Author) Other; Dias, T (Author) Other; Barbosa, A (Author) Other; Teixeira, P (Author) Other; Ribeiro, J (Author) Other; Dias, A (Author) Other; Caeiro, D (Author) Other; Fonseca, M (Author) Other; Teixeira, M (Author) Other; Oliveira, M (Author) Other; Goncalves, H (Author) Other; Primo, J (Author) Other; Rodrigues, A (Author) Other; Gama, V (Author) Other; Braga, P (Author) Other; Fontes-Carvalho R (Author) FMUP

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ISI Web of Knowledge - 5 Citations

Scopus - 5 Citations

Other information

Authenticus ID: P-00S-K7X

DOI: 10.1016/j.repc.2020.02.011

Abstract (EN): Introduction: Transcatheter aortic valve implantation (TAVI) is associated with cardiac electrical disturbances. However, beyond the risks of pacemaker implantation, few studies have performed a detailed assessment of the effects of TAVI on several cardiac electrical properties. Objectives: To assess the frequency and type of electrocardiographic disturbances following TAVI, according to the type of prostheses and to assess predictors of these disturbances. Methods: We performed a detailed retrospective analysis of all electrocardiograms in patients who underwent TAVI, before and after the procedure, at a tertiary center from August 2007 to October 2016. Patients with permanent pacemakers were excluded. Results: We included 182 patients (78 +/- 8 years; 56% female) and self-expanding prostheses (SEP) were implanted in 54%. Most patients (80%) were in sinus rhythm at baseline. After TAVI, 21% of patients developed new-onset atrial fibrillation and there was a significant increase in PR interval at discharge (186 +/- 41 ms vs. 176 +/- 32; p=0.003), which was not maintained after at sixmonth follow-up (181 +/- 35 ms, p=0.06). There was also a significant increase in QRS duration at discharge (129 +/- 28 ms vs. 114 +/- 25 at baseline p<0.0001), which persisted at six-months (122 +/- 28 ms, p<0.0001). New-onset left-bundle branch block (LBBB) was observed in 25% of patients. The depth of valve implantation was a predictor of new LBBB at discharge after multivariate analysis (OR 37.6, 95% CI 14.6-65.2, p=0.001). Conclusions: The main electrocardiographic disturbances post TAVI were PR prolongation, increased QRS and new-onset LBBB. These disturbances were more pronounced in patients undergoing SEP implantation and tended to improve at six-month follow-up. The depth of valve implantation was a predictor of conduction disturbances. (C) 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10