Ventricular arrhythmias before and after transcatheter aortic valve implantation

Conti, Sergio; Pruiti, Giusi Paola; Tempio, Donatella; Romanò, Sara; Tavano, Elisa; Liotta, Claudio; Grazia, Angelo Di; Capodanno, Davide; Tamburino, Corrado; Calvi, Valéria

doi:10.1093/eurheartj/eht310.p4947

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“…Previous studies showed that ventricular arrhythmias are frequent in patients undergoing TAVI and decrease in incidence and severity during follow-up after the first month, 4 , 10 , 13 but no previous study investigated the prognostic implications of frequent or complex ventricular arrhythmias in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9] Whether the detection of ventricular arrhythmias has any prognostic implications in these patients, however, has poorly been investigated. [10][11][12][13] and 2021, who underwent TAVI for severe aortic stenosis, defined as Doppler aortic valve area (D-AVA) less than 1.0 cm 2 (or indexed D-AVA <0.60 cm 2 /m 2 ), resulting in typical symptoms, including dyspnoea, syncope or presyncope and angina.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9] Whether the detection of ventricular arrhythmias has any prognostic implications in these patients, however, has poorly been investigated. [10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

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Impact on clinical outcome of ventricular arrhythmias in patients undergoing transcatheter aortic valve implantation

Cambise,

Gnan,

Tremamunno

et al. 2024

Journal of Cardiovascular Medicine

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Background Transcatheter aortic valve implantation (TAVI) has become a largely used treatment for severe aortic stenosis. There are limited data, however, about predictors of long-term prognosis in this population. In this study, we assessed whether ventricular arrhythmias may predict clinical outcomes in patients undergoing TAVI. Methods and results We performed a 24 h ECG Holter monitoring in 267 patients who underwent TAVI for severe aortic stenosis within 30 days from a successful procedure. The occurrence of frequent premature ventricular complexes (PVCs; ≥30/h), polymorphic PVCs and nonsustained ventricular tachycardia (NSVT) was obtained for each patient. Clinical outcome was obtained for 228 patients (85%), for an average follow-up of 3.5 years (range 1.0–8.6). Cardiovascular events (CVEs; cardiovascular death or resuscitated cardiac arrest) occurred in 26 patients (11.4%) and 63 patients died (27.6%). Frequent PVCs but not polymorphic PVCs and NSVT were found to be associated with CVEs at univariate analysis. Frequent PVCs were indeed found in 12 patients with (46.2%) and 35 without (17.3%) CVEs [hazard ratio 2.30; 95% confidence interval (CI) 1.03–5.09; P = 0.04], whereas polymorphic PVCs were found in 11 (42.3%) and 54 (26.7%) patients of the two groups, respectively (hazard ratio 1.44; 95% CI 0.64–3.25; P = 0.38), and NSVT in 9 (34.6%) and 43 patients of the two groups, respectively (hazard ratio 1.18; 95% CI 0.48–2.87; P = 0.72). Frequent PVCs, however, were not significantly associated with CVEs at multivariate Cox regression analysis (hazard ratio 1.53; 95% CI 0.37–6.30; P = 0.56). Both frequent PVCs, polymorphic PVCs and NSVT showed no significant association with mortality. Conclusion In our study, the detection of frequent PVCs at Holter monitoring after TAVI was a predictor of CVEs (cardiovascular death/cardiac arrest), but this association was lost in multivariable analysis.

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Section: Discussionmentioning

confidence: 99%