Open AccessCARDIAC CONDUCTION DISTURBANCES FOLLOWING TRANSAPICAL «MEDLAB-KT» AORTIC VALVE IMPLANTATION: FIRST RESULTS
Author(s) -
O. V. Popylkova,
С. С. Дурманов,
В.В. Базылев,
А. Б. Воеводин
Publication year - 2019
Publication title -
vestnik aritmologii
Language(s) - English
Resource type - Journals
eISSN - 2658-7327
pISSN - 1561-8641
DOI - 10.35336/vf-2019-2-14-18
Subject(s) - medicine , right bundle branch block , cardiology , left bundle branch block , atrioventricular block , heart block , electrical conduction system of the heart , block (permutation group theory) , bundle branch block , valve replacement , left axis deviation , concomitant , electrocardiography , heart failure , stenosis , geometry , mathematics
Aim: to assess cardiac conduction disturbances after transcatheter aortic valve replacement (TAVR) with the “MedLab-KT” device in early postoperative period. Methods. The study comprised 80 patients (mean age 72,4±5,1 years; 42,5% males) undergoing successful TAVR with the “MedLab-KT”. Before operation, all patients were evaluated with 12-lead ECG and 24-hour Holter monitoring, transthoracic and transesophageal echocardiography, computed tomography, coronarography. In 29 (36,3%) patients cardiac conduction abnormalities were detected before operation: 1st degree atrioventricular (AV) block was found in 17 patients, including concomitant left anterior hemiblock (LAH) in 7 patients, and right bundle branch block (RBBB) in 3 (LAH+RBBB). Second degree AV-block type 1 was found in 1 patient. LAH – in 2, RBBB – in 5, and left bundle branch block (LBBB) – in 4. Post-operative follow-up was limited to hospital stay (13,4±7,4 days). Results. De-novo conduction abnormalities (reversible and irreversible) were detected in 41 patients (51,3%). Post-TAVR complete AV-block was found in 6 (7,5%) patients, and required temporal pacing. In 4 of those patients AV-block was transient and resolved within 1 day. In 2 (2,5%) patients permanent pacing was required due to irreversible distal AV-block. In one case AV-block developed 2 days after TAVR in a patient with pre-existent 1st degree AV-block in combination with LAH+RBBB. Another patient developed complete AV-block at 3d day after TAVR; in this case there was pre-existent 1st degree AV-block plus LAH. Persistent interventricular block was found in 35 patients: complete LBBB - in 17 patients and complete RBBB – in 1 patient. There were no statistically significant predictors of conduction disturbance development following TAVR.