Electrocardiographic Predictors of Long‐Term Cardiac Pacing Dependency Following Transcatheter Aortic Valve Implantation

Abstract

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.

Pacemaker memory in post‐TAVI patients: Who should benefit from permanent pacemaker implantation?

“…We also demonstrated that the majority of patients implanted for paroxysmal CAVB (83%) had a significant VP percentage at the first pacemaker interrogation, suggesting the need for PPI in this clinical situation. Finally, one episode of transient CAVB seems Except for the initial conduction disorder, we did not find any predictive factors of pacemaker use contrary to Naveh et al 13 In this study, PR interval < 210 ms and PR interval increment of < 28 ms recorded during the immediate post-TAVI period had a high negative predictive value for long-term pacemaker dependency (respectively 93% and 95%). Akin et al also found that a PR interval longer than 200 ms post-TAVI was a predictive factor for the development of high degree AV block during follow-up.…”

“…Except for the initial conduction disorder, we did not find any predictive factors of pacemaker use contrary to Naveh et al . In this study, PR interval < 210 ms and PR interval increment of < 28 ms recorded during the immediate post‐TAVI period had a high negative predictive value for long‐term pacemaker dependency (respectively 93% and 95%).…”

Cardiac conduction abnormalities associated with pacemaker implantation after transcatheter aortic valve replacement

“…Importantly, only new conduction abnormalities, those that had not been present prior to the procedure, were recorded. This study did not examine the effects of preexisting conduction abnormalities as others have done so in the past . Our study also did not focus on valve type as the long study period meant that several different models were used and this was not the emphasis of our research.…”

Permanent pacemaker insertion in patients with conduction abnormalities post transcatheter aortic valve replacement: a review and proposed guidelines

“…Baseline and post-procedural first degree AV Blocks (AVB) as well as a left anterior hemiblock have been studied as predictors of long term dependency on PPM, however have not qualified as independent predictors of advanced conduction abnormality post-TAVR (35). An implantation depth of less than 6 mm and newer designs that allow implantation higher in the LVOT also show a lower trend in conduction abnormalities and PPM implants (6,8,29).…”