title: Frequency of conduction disturbances after transcatheter implantation of an Edwards Sapien aortic valve prosthesis.
abstract: We evaluated the incidence of conduction abnormalities and requirement for permanent pacemaker in patients undergoing transcatheter aortic valve implantation (TAVI) with the Edwards Sapien prosthesis. In 2009, >8,000 patients were treated with TAVI using 1 of the 2 commercialized models of bioprosthesis (Edwards Sapien, Edwards Lifesciences, Irvine, California; and CoreValve, Medtronic, Irvine, California). Occurrence of conduction abnormalities including complete atrioventricular block requiring permanent pacemaker has been reported after TAVI with the 2 models of valve, more frequently with the CoreValve. We analyzed standard 12-lead electrocardiograms of 69 consecutive patients in whom an Edwards Sapien prosthesis was successfully implanted. Electrocardiograms were examined before treatment, at day 1, and at 1-month follow-up. Heart rate, PR and QT intervals and QRS duration were measured and the presence of a first-, second-, or third-degree atrioventricular block was documented. There was a slight increase in heart rate and a discrete decrease in QT interval at day 1. These values had returned to baseline values at 1 month. There was no change in PR interval but a transitory increase in QRS duration was noted. Frequency of left bundle branch block increased from 14.5% at baseline to 27.5% at day 1 with a decreased incidence at day 30 (21.3%). Permanent pacemaker was required in only 3 patients (4.3%). In conclusion, in our experience, conductive disorders and requirement of a definitive pacemaker after implantation of an Edwards Sapien aortic bioprosthesis are infrequent. The physical properties of this prosthesis may explain this observation.
authors: Department of Cardiology, Rouen University Hospital and INSERM U, University of Rouen, France.
authors: Matthieu
authors: M
authors: Godin
authors: Helene
authors: H
authors: Eltchaninoff
authors: Akira
authors: A
authors: Furuta
authors: Christophe
authors: C
authors: Tron
authors: Frederic
authors: F
authors: Anselme
authors: Karim
authors: K
authors: Bejar
authors: Carlos
authors: C
authors: Sanchez-Giron
authors: Fabrice
authors: F
authors: Bauer
authors: Pierre-Yves
authors: PY
authors: Litzler
authors: Jean-Paul
authors: JP
authors: Bessou
authors: Alain
authors: A
authors: Cribier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D001705:Bioprosthesis / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006327:Heart Block / Q000453:epidemiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome