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Journal of cardiovascular electrophysiology v.28 no.2, 2017년, pp.216 - 223   SCI SCIE
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Electrocardiographic Predictors of Long‐Term Cardiac Pacing Dependency Following Transcatheter Aortic Valve Implantation

NAVEH, SIVAN (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; PERLMAN, GIDON Y. (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; ELITSUR, YAIR (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; PLANER, DAVID (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; GILON, DAN (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; LEIBOWITZ, DAVID (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; LOTAN, CHAIM (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; DANENBERG, HAIM (The Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel ) ; ALCALAI, RONNY (The Heart Institute, Had ) ;
  • 초록  

    Pacing Dependency Following TAVI Background Conduction disorders requiring permanent pacemaker (PPM) implantation are a known complication of transcatheter aortic valve implantation (TAVI). Indications for permanent pacing in this setting are still controversial. The study aim was to characterize the natural history of conduction disorders related to TAVI, and to identify predictors for long‐term pacing dependency. Methods Consecutive patients who underwent TAVI were included in this prospective observational study. The conduction system was investigated by reviewing 12‐lead ECGs during hospitalization and up to 1‐year follow‐up and by analyzing pacemaker interrogation data. Multivariate analysis was performed in order to identify independent predictors for pacemaker dependency. Results Of 110 patients included in the analysis, 38 (34.5%) underwent PPM implantation. Of those, 26 (68.4%) had a long‐term pacing dependency (required PPM), while 12 (31.6%) did not (not‐required PPM). Logistic regression revealed that baseline RBBB (P = 0.01, OR = 18.0), baseline PR interval (P = 0.019, OR = 1.14), post‐TAVI PR interval and the change in PR interval from baseline (P Conclusions Increased pre‐ and postprocedural PR intervals and pre‐existing RBBB are reliable predictors for long‐term PPM dependency, while left bundle branch block or QRS width are misleading factors. Our study suggests that the decision for implanting PPM after TAVI should be based mostly on the prolongation of the PR interval.


  • 주제어

    aortic stenosis .   conduction system .   heart block .   permanent pacemaker .   transcatheter aortic valve implantation.  

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