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Usefulness of Temporary Pacing in Patients With New Left Bundle Branch Block During Transcatheter Aortic Valve Implantation.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2022 Aug 01; Vol. 176, pp. 105-111. Date of Electronic Publication: 2022 May 28. - Publication Year :
- 2022
-
Abstract
- New-onset left bundle branch block (NLBBB) is the most common complication after transcatheter aortic valve implantation (TAVI). Expert consensus recommends temporary transvenous pacemaker (TTVP) support for 24 hours in these patients. To date, no study has examined TTVP use during the index hospitalization in detail. Therefore, we aimed to assess TTVP use in patients with TAVI who developed NLBBB. In this prospective observational study, we performed a detailed analysis of 24-hour telemetry in patients who developed NLBBB during TAVI. Baseline characteristics and procedural and postprocedural data were recorded. The primary outcome was pacing by the TTVP. We evaluated inappropriate TTVP use, electrophysiology study findings, permanent pacemaker (PPM) implantation, and NLBBB resolution. A total of 83 patients (74.4 ± 8.7 years, 41% female) developed NLBBB during TAVI. During index hospitalization, 1 patient (1%) required TTVP because of complete heart block and received a PPM. Five of the 83 (6%) patients were inappropriately paced, and 1 patient (1%) had ventricular fibrillation, likely secondary to TTVP. A total of 34 patients (41%) underwent electrophysiology study during hospitalization, with 4 of 83 (5%) subsequently receiving a PPM. One (1%) patient died during hospitalization, and 9 patients were lost to follow-up because of the COVID-19 pandemic. Of the remaining 73 patients with a 30-day follow-up, NLBBB had resolved in 36 (49%) at 30 days, and 2 (3%) were readmitted with complete heart block and received PPM. In conclusion, in patients with TAVI who develop NLBBB, temporary pacing is rarely necessary, may carry additional risks to the patient, and prolong hospitalization time.<br /> (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Subjects :
- Aortic Valve surgery
Arrhythmias, Cardiac therapy
Bundle-Branch Block epidemiology
Bundle-Branch Block etiology
Bundle-Branch Block therapy
Cardiac Pacing, Artificial adverse effects
Female
Humans
Male
Pandemics
Postoperative Complications epidemiology
Treatment Outcome
Aortic Valve Stenosis complications
Atrioventricular Block etiology
COVID-19 epidemiology
Pacemaker, Artificial adverse effects
Transcatheter Aortic Valve Replacement adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 176
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 35641348
- Full Text :
- https://doi.org/10.1016/j.amjcard.2022.04.016