Electrophysiology testing to stratify patients with left bundle branch block after transcatheter aortic valve implantation

30Citations
Citations of this article
27Readers
Mendeley users who have this article in their library.

Abstract

Background-—Left bundle branch block (LBBB) is common after transcatheter aortic valve implantation (TAVI) and is an indicator of subsequent high-grade atrioventricular block (HAVB). No standardized protocol is available to identify LBBB patients at risk for HAVB. The aim of the current study was to evaluate the safety and efficacy of an electrophysiology study tailored strategy in patients with LBBB after TAVI. Methods and Results-—We prospectively analyzed consecutive patients with LBBB after TAVI. An electrophysiology study was performed to measure the HV-interval the day following TAVI. In patients with normal His-ventricular (HV)-interval ≤55 ms, a loop recorder was implanted (ILR-group), whereas pacemaker implantation was performed in patients with prolonged HV-interval >55 ms (PM-group). The primary end point was occurrence of HAVB during a follow-up of 12 months. Secondary end points were symptoms, hospitalizations, adverse events because of device implantation or electrophysiology study, and death. Of 373 patients screened after TAVI, 56 patients (82±6 years, 41% male) with LBBB were included. HAVB occurred in 4 of 41 patients (10%) in the ILR-group and in 8 of 15 patients (53%) in the PM-group (P<0.001). We did not identify other predictors for HAVB than the HV interval. The negative predictive value for the cut-off of HV 55 ms to detect HAVB was 90%. No HAVB-related syncope occurred in the 2 groups. Conclusions-—An electrophysiology study tailored strategy to LBBB after TAVI with a cut-off of HV >55 ms is a feasible and safe approach to stratify patients with regard to developing HAVB during a follow-up of 12 months.

References Powered by Scopus

Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery

6112Citations
N/AReaders
Get full text

213 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

1772Citations
N/AReaders
Get full text

Treatment of calcific aortic stenosis with the percutaneous heart valve: Mid-term follow-up from the initial feasibility studies: The French experience

695Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Incidence, Predictors, and Implications of Permanent Pacemaker Requirement After Transcatheter Aortic Valve Replacement

151Citations
N/AReaders
Get full text

Management of conduction disorders after transcatheter aortic valve implantation: results of the EHRA survey

21Citations
N/AReaders
Get full text

Validation of the 2019 Expert Consensus Algorithm for the Management of Conduction Disturbances After TAVR

15Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Knecht, S., Schaer, B., Reichlin, T., Spies, F., Madaffari, A., Vischer, A., … Kühne, M. (2020). Electrophysiology testing to stratify patients with left bundle branch block after transcatheter aortic valve implantation. Journal of the American Heart Association, 9(5). https://doi.org/10.1161/JAHA.119.014446

Readers over time

‘19‘20‘21‘22‘23‘24036912

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 5

56%

Professor / Associate Prof. 2

22%

Researcher 2

22%

Readers' Discipline

Tooltip

Medicine and Dentistry 8

100%

Save time finding and organizing research with Mendeley

Sign up for free
0