PACEMAKER FOLLOW-UP AFTER TAVI
L.P. Papavasileiou1,2, K. Spargias3, G. Zervopoulos1, M. Chrisocheris2,
A. Chalapas2, K. Bellos2,4, L. Santini2, G. Forleo2, T. Apostolopoulos1:
1. Electrophysiology Pacemaker and ICD Unit, Hygeia Hospital, Athens, Greece. 2. University Hospital of Rome "Tor Vergata", Cardiology Department, Rome, Italy. 3. Transcutaneous Heart Valves Department, Hygeia Hospital, Athens, Greece.
4. 1rst Cardiothoracic Surgery Department, Hygeia Hospital, Athens, Greece
Introduction: : Incidence of pacemaker (PM) implantation after Transcatheter Aortic-Valve Implantation (TAVI) is 6.5%-40%. Most common indications are: complete atrioventricular block (BAV), 1rst degree AV block and left bundle branch block (LBBB), sick sinus rhythm (SSS).
Methods: We evaluated the follow-up (device interrogation) of 14 patients that underwent PM implantation after TAVI (reason of implantation was: 7 pts for BAV, 5 pts for 1rst degree AV block and LBBB, 2 for left and right bundle branch block alternance, 1 pts for 2:1 AV block).
Results: Patients with preexisting right bandle branch block (RBBB) that underwent Corvalve implantation, patients with RBBB+LBBB alternance and with 2:1 AV block had 100% of ventricular pacing during follow-up. Patients with BAV that underwent Edwards Sapien valve implantation, with restoration of conduction 24 hours after the procedure and pts with 1rst degree AV block and LBBB had 0% of ventricular pacing during follow-up.
Conclusions: Implantation of PM after TAVI is performed too early in the post operatory period. The preexisting RBBB and the Corvalve implantation determine irreversible AV block. The presence of reversible AV block after TAVI with the Edwards Sapien valve and the presence of 1rst AV block with LBBB do not require pacing over time.
