Predictors of Complete Heart Block After Transcoronary Ablation of Septal Hypertrophy

Abstract

Measurement of intracardiac conduction during TASH improves the safety of the procedure by enabling identification of patients who are at risk of complete heart block after TASH. The duration of prophylactic temporary pacemaker backup should be prolonged up to day 6 after TASH in patients at increased risk (patients with retrograde atrioventricular block and at least 1 additional risk factor).

Alcohol-Based Septal Ablation of Interventricular Septum With Contrast Echocardiographic Control

“…Самым частым осложнением ССА становится полная атриовентрикулярная блокада, требующая импланта-ции кардиостимулятора. Острая самостоятельно купирующаяся полная атриовентрикулярная блокада встречается приблизительно в половине случаев [30,34,[38][39][40].…”

“…В конечном счете, 10% пациентов после ССА необходимо имплантировать постоянный кардиостимулятор [35]. Предикторами последующей имплантации постоянных кардиости-муляторов служат блокада левой ножки пучка Гиса, атриовентрикулярная блокада первой степени, раз-вившаяся после процедуры, развитие новой степени атриовентрикулярной блокады или нарушения вну-трижелудочковой проводимости [39,[40][41][42].…”

Incidence and Predictors of Late Complete Heart Block After Alcohol Septal Ablation Treatment of Hypertrophic Obstructive Cardiomyopathy

“…Complete heart block (CHB) requiring permanent pacemaker (PPM) implantation is a known common acute complication of the ASA procedure, with a reported incidence of 9-22%. 5,6,[13][14][15][16] By targeting the proximal septal perforating coronary arteries, a dense infarct in the basal septum is created, frequently affecting the proximal His-Purkinje system, and potentially resulting in right bundle branch block (RBBB) or CHB. By contrast, surgical septal myectomy may result in left bundle branch block (LBBB) in approximately 40% of cases and in CHB in 4-6.8% of cases.…”

The role of electrophysiologic study in high‐risk patients with new‐onset conduction disturbances following alcohol septal ablation for hypertrophic obstructive cardiomyopathy

“…Electrophysiology study (EPS) has traditionally be used to assess heart block risk in several high-risk patients cohorts, 4 but such an approach has only be studied for intraprocedural recording during ASA. 5 We hypothesized that postprocedural EPS may be useful in high-risk patients.…”

“…To the best of our knowledge, this is the first study explicitly assessing patients with transient CHB or RBBB using an invasive EPS after ASA. Previous research focused predominantly on predictors from the preprocedural 12-lead ECG, 2,8 prolonged monitoring, 5,9,10 or on detection of ventricular arrhythmias. 11 Lawrenz et al 5 assessed the utility of an EPS in patients undergoing ASA.…”