Recovery of atrioventricular conduction in patients with heart block after transcatheter aortic valve replacement

2017 ◽  
Vol 28 (10) ◽  
pp. 1196-1202 ◽  
Author(s):  
Colin A. Raelson ◽  
James Gabriels ◽  
Jonathan Ruan ◽  
James E. Ip ◽  
George Thomas ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Block ◽  
Transcatheter Aortic Valve Replacement ◽  
Atrioventricular Conduction ◽  
Transcatheter Aortic Valve

scholarly journals Mechanisms of Heart Block after Transcatheter Aortic Valve Replacement – Cardiac Anatomy, Clinical Predictors and Mechanical Factors that Contribute to Permanent Pacemaker Implantation

2015 ◽  
Vol 04 (2) ◽  
pp. 81 ◽  
Author(s):  
Mark Young Lee ◽  
Srinath Chilakamarri Yeshwant ◽  
Sreedivya Chava ◽  
Daniel Lawrence Lustgarten ◽  
◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Heart Block ◽  
Transcatheter Aortic Valve Replacement ◽  
Permanent Pacemaker ◽  
Cardiac Conduction ◽  
Clinical Predictors ◽  
Conduction Disturbances ◽  
Transcatheter Aortic Valve

Transcatheter aortic valve replacement (TAVR) has emerged as a valuable, minimally invasive treatment option in patients with symptomatic severe aortic stenosis at prohibitive or increased risk for conventional surgical replacement. Consequently, patients undergoing TAVR are prone to peri-procedural complications including cardiac conduction disturbances, which is the focus of this review. Atrioventricular conduction disturbances and arrhythmias before, during or after TAVR remain a matter of concern for this high-risk group of patients, as they have important consequences on hospital duration, short- and long-term medical management and finally on decisions of device-based treatment strategies (pacemaker or defibrillator implantation). We discuss the mechanisms of atrioventricular disturbances and characterise predisposing factors. Using validated clinical predictors, we discuss strategies to minimise the likelihood of creating permanent high-grade heart block, and identify factors to expedite the decision to implant a permanent pacemaker when the latter is unavoidable. We also discuss optimal pacing strategies to mitigate the possibility of pacing-induced cardiomyopathy.

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