Rapid reversal of heart failure by correcting left bundle branch block induced by transcatheter aortic valve replacement

Zhang, Jiefang; Yu, Fei; Wang, Bei; Fu, Guosheng

doi:10.1111/pace.14132

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…33 Maintenance of left and right ventricular synchrony is important in TAVI patients and there is currently no consensus guideline on management following leadless pacemaker extraction. 34 Conduction system pacing may alleviate such long-term concerns and has been shown to be a feasible option in TAVI patients. [35][36][37] However, similar to leadless pacemakers, the long-term benefit of conduction system pacing in this patient population will require further validation.…”

Section: Discussionmentioning

confidence: 99%

Leadless pacemaker with transcatheter aortic valve implantation: A single‐center experience

Gao

Kherallah

Koetting

et al. 2023

Pacing Clinical Electrophis

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Background:The safety and efficacy of leadless pacemakers (LP) in transcatheter aortic valve implant (TAVI) patients is not well known due to paucity of data. Herein, we compared outcomes between leadless pacemakers to traditional dual chamber pacemakers (DCP) following TAVI.Methods: A single-center retrospective study was conducted, including a total of 27 patients with LP and 33 patients with DCP after TAVI between November 2013 and May 2021. We compared baseline demographics, pacemaker indications, complication rates, percent pacing, and ejection fractions.Results: Leading indications for pacemaker implant were complete heart block (74% LP, 73% DCP) and high degree atrioventricular block (26% LP, 21% DCP). Twenty-two (82%) LP patients had devices implanted in the right ventricular septal-apex. Three (9%) DCP patients required rehospitalization for pocket related complications. Zero pacemaker-related mortality was observed in both groups. Frequency of ventricular pacing and ejection fraction was similar between LP and DCP groups. Conclusion:From this single-center retrospective study, LP implant was feasible following TAVI and was found to have comparable performance to DCPs. LPs may be a reasonable alternative in TAVI patients where single ventricular pacing is indicated.Larger studies are required to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Leadless pacemaker with transcatheter aortic valve implantation: A single‐center experience

Gao

Kherallah

Koetting

et al. 2023

Pacing Clinical Electrophis

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“…The success rate of LBBP was significantly higher than HBP (93% vs 63%), while the success rate of HBP distinctly varied among different valve types (69% in the Edward Sapien valve compared with 44% in patients with CoreValve; p < 0.05). Zhang et al [69] reported a LBBP case with heart failure by correcting TAVR induced LBBB with a stable capture and correction threshold, which failed to be corrected by HBP during the procedure. This is because LBBP is delivered by bypassing the pathologic region.…”

Section: Hpcsp In Tavr Related Lbbbmentioning

confidence: 99%

“…Studies to evaluate HPCSP after TAVR are listed as follows (Table 2, Ref. [63,64,[66][67][68][69][70]). Although the sample size of the above studies is small, the results are basically consistent.…”

Section: Hpcsp In Tavr Related Lbbbmentioning

confidence: 99%

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Current Opinions on New-Onset Left Bundle Branch Block after Transcatheter Aortic Valve Replacement and the Search for Physiological Pacing

Zhang¹,

Pan²,

Wang³

et al. 2022

Rev. Cardiovasc. Med.

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Transcatheter aortic valve replacement possesses a high validity for patients with aortic stenosis who are considered high risk for aortic valve replacement surgery, nowadays it is also considered for patients with intermediate risk or even lower risk in certain situations. The incidence of new conduction abnormalities remains to be a tough problem, in particular, left bundle branch block. New-onset left bundle branch block is a major concern despite improvements in valve technology, and it may affect postoperative prognosis. Understanding the anatomical relationship between the conduction system and the aortic root, clarify factors related to the procedure, devices, and patients, might help to reduce the conduction abnormalities. Physiological pacing has emerged as a reasonable pacing strategy for patients with cardiac insufficiency post-valve replacement, especially combined with left bundle branch block. The purpose of this review is to summarize the current opinion on the incidence of new-onset left bundle branch block associated with transcatheter aortic valve replacement, to offer insights into its anatomical and procedural causes, clinical consequences, and more importantly, the prospect of applying physiological pacing as a therapeutic method for these patients.

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“…Several small-sample studies have evaluated the feasibility of CSP in post-TAVR patients. However, comparisons between CSP and RVP in post-TAVR patients have not been well-described ( 3 , 6 , 7 ). In this study, we assessed the feasibility of CSP in a cohort of post-TAVR patients and compared the procedural and clinical outcomes of TAVR with RVP.…”

Section: Introductionmentioning

confidence: 99%

Conduction System Pacing for Post Transcatheter Aortic Valve Replacement Patients: Comparison With Right Ventricular Pacing

Niu

Liu

et al. 2021

Front. Cardiovasc. Med.

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Introduction: For patients who develop atrioventricular block (AVB) following transcatheter aortic valve replacement (TAVR), right ventricular pacing (RVP) may be associated with adverse outcomes. We assessed the feasibility of conduction system pacing (CSP) in patients who developed AVB following TAVR and compared the procedural and clinical outcomes with RVP.Methods: Consecutive patients who developed AVB following TAVR were prospectively enrolled, and were implanted with RVP or CSP. Procedural and clinical outcomes were compared among different pacing modalities.Results: A total of 60 patients were enrolled, including 10 who were implanted with His bundle pacing (HBP), 20 with left bundle branch pacing (LBBP), and 30 with RVP. The HBP group had significantly lower implant success rate, higher capture threshold, and lower R-wave amplitude than the LBBP and RVP groups (p < 0.01, respectively). The RVP group had a significantly longer paced QRS duration (153.5 ± 6.8 ms, p < 0.01) than the other two groups (HBP: 121.8 ± 8.6 ms; LBBP: 120.2 ± 10.6 ms). During a mean follow-up of 15.0 ± 9.1 months, the LBBP group had significantly higher left ventricular ejection fraction (LVEF) (54.9 ± 6.7% vs. 48.9 ± 9.1%, p < 0.05) and shorter left ventricular end-diastolic diameter (LVEDD) (49.7 ± 5.6 mm vs. 55.0 ± 7.7 mm, p < 0.05) than the RVP group. While the HBP group showed trends of higher LVEF (p = 0.016) and shorter LVEDD (p = 0.017) than the RVP group. Four patients in the RVP group died—three deaths were due to progressive heart failure and one was due to non-cardiac reasons. One death in the LBBP group was due to the non-cardiac reasons.Conclusions: CSP achieved shorter paced QRS duration and better cardiac structure and function in post-TAVR patients than RVP. LBBP had a higher implant success rate and better pacing parameters than HBP.

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Rapid reversal of heart failure by correcting left bundle branch block induced by transcatheter aortic valve replacement

Cited by 3 publications

References 11 publications

Leadless pacemaker with transcatheter aortic valve implantation: A single‐center experience

Leadless pacemaker with transcatheter aortic valve implantation: A single‐center experience

Current Opinions on New-Onset Left Bundle Branch Block after Transcatheter Aortic Valve Replacement and the Search for Physiological Pacing

Conduction System Pacing for Post Transcatheter Aortic Valve Replacement Patients: Comparison With Right Ventricular Pacing

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