Baseline HV-interval predicts complete AV-block secondary to transcatheter aortic valve implantation
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Baseline HV-interval predicts complete AV-block secondary to transcatheter aortic valve implantation. / Shin, Dong-In; Merx, Marc W; Meyer, Christian; Kirmanoglou, Kiriakos; Hellhammer, Katharina; Ohlig, Jan; Katsani, Dimitra; Zeus, Tobias; Westenfeld, Ralf; Eickholt, Christian; Linke, Axel; Kelm, Malte.
in: ACTA CARDIOL, Jahrgang 70, Nr. 5, 10.2015, S. 574-580.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Baseline HV-interval predicts complete AV-block secondary to transcatheter aortic valve implantation
AU - Shin, Dong-In
AU - Merx, Marc W
AU - Meyer, Christian
AU - Kirmanoglou, Kiriakos
AU - Hellhammer, Katharina
AU - Ohlig, Jan
AU - Katsani, Dimitra
AU - Zeus, Tobias
AU - Westenfeld, Ralf
AU - Eickholt, Christian
AU - Linke, Axel
AU - Kelm, Malte
PY - 2015/10
Y1 - 2015/10
N2 - PURPOSE: Development of AV-block is a frequent complication associated with transcatheter aortic valve implantation (TAVI). To date little is known about the predictive value of the HV-interval prior to TAVI with respect to the risk of AV-block development.METHODS AND RESULTS: HV-interval was determined in 25 consecutive elderly patients with severe aortic valve stenosis (AS) before and immediately after TAVI. All patients subsequently underwent TAVI and 8 of these 25 patients (32%) developed complete AV-block during the TAVI procedure requiring permanent pacemaker implantation. Six of these 8 patients (75%) had marked HV prolongation (>54 ms). Pre-procedural HV-interval was significantly prolonged in the subgroup developing complete AV-block (62.1 ms±13.0 vs 49.2 ms±12.9; P=0.029). Prolongation of the HV-interval above 54 ms was associated with a higher rate of complete AV-block (sensitivity 75.0%, specificity 77.8%, P=0.01).CONCLUSIONS: HV-interval was prolonged in approximately one third of our elderly patients with aortic valve stenosis and associated with a high rate of complete AV-block following TAVI. HV-interval is easily obtained during TAVI screening procedures, thus facilitating identification of patients at risk for complete AV-block due to TAVI and consequently enabling bespoke risk management.
AB - PURPOSE: Development of AV-block is a frequent complication associated with transcatheter aortic valve implantation (TAVI). To date little is known about the predictive value of the HV-interval prior to TAVI with respect to the risk of AV-block development.METHODS AND RESULTS: HV-interval was determined in 25 consecutive elderly patients with severe aortic valve stenosis (AS) before and immediately after TAVI. All patients subsequently underwent TAVI and 8 of these 25 patients (32%) developed complete AV-block during the TAVI procedure requiring permanent pacemaker implantation. Six of these 8 patients (75%) had marked HV prolongation (>54 ms). Pre-procedural HV-interval was significantly prolonged in the subgroup developing complete AV-block (62.1 ms±13.0 vs 49.2 ms±12.9; P=0.029). Prolongation of the HV-interval above 54 ms was associated with a higher rate of complete AV-block (sensitivity 75.0%, specificity 77.8%, P=0.01).CONCLUSIONS: HV-interval was prolonged in approximately one third of our elderly patients with aortic valve stenosis and associated with a high rate of complete AV-block following TAVI. HV-interval is easily obtained during TAVI screening procedures, thus facilitating identification of patients at risk for complete AV-block due to TAVI and consequently enabling bespoke risk management.
KW - Aged
KW - Aortic Valve/physiopathology
KW - Aortic Valve Stenosis/complications
KW - Arrhythmias, Cardiac/complications
KW - Atrioventricular Block/diagnosis
KW - Cardiac Catheterization/adverse effects
KW - Cardiac Pacing, Artificial
KW - Female
KW - Heart Conduction System/physiopathology
KW - Heart Rate
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Humans
KW - Male
KW - Middle Aged
KW - Patient Selection
KW - Predictive Value of Tests
KW - Prosthesis Design
KW - Risk Assessment
KW - Risk Factors
KW - Treatment Outcome
U2 - 10.2143/AC.70.5.3110518
DO - 10.2143/AC.70.5.3110518
M3 - SCORING: Journal article
C2 - 26567817
VL - 70
SP - 574
EP - 580
JO - ACTA CARDIOL
JF - ACTA CARDIOL
SN - 0001-5385
IS - 5
ER -