title: Predictive factors for pacemaker requirement after transcatheter aortic valve implantation.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) has been established as a treatment option for inoperable patients with symptomatic aortic valve stenosis. However, patients suffer frequently from conduction disturbances after TAVI.
  
  
  METHODS
  Baseline, procedural as well as surface and intracardiac ECG parameters were evaluated for patients treated with TAVI and a comparison between patients requiring pacemaker with those not suffering from relevant conduction disorders were done.
  
  
  RESULTS
  TAVI was successfully in all patients (n=45). Baseline surface and intracardiac ECG recording revealed longer PQ (197.1±51.2 msec versus 154.1±32.1 msec; p<0.001), longer AH (153.6±43.4 msec versus 116.1±31.2 msec; p<0.001) and HV interval (81.7±17.8 msec versus 56.8±8.5 msec; p<0.001) in patients with need for a pacemaker (n=23) versus control group (n=22); furthermore, 7-day follow-up analysis showed a higher prevalence of new left bundle branch block (LBBB) (87.0% versus 31.9%; p<0.001). Multivariate analysis revealed that only new LBBB, QRS duration >120 msec and a PQ interval >200 msec immediately (within 60 minutes) after implantation of the aortic valve were predictors for high-grade (type II second-degree and third-degree) AV block. Other clinical parameters as well as baseline electrocardiographic parameters had no impact on critical conduction delay.
  
  
  CONCLUSIONS
  Cardiac conduction disturbances are common after TAVI. The need for pacing after TAVI is predictable by surface ECG evaluation immediately (within 60 minutes) after the procedure.
authors.affiliation: Heart Center Rostock, Department of Internal Medicine I, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str, 6, Rostock, 18057, Germany. ibrahim.akin@med.uni-rostock.de
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akin
authors.forename: Stephan
authors.initials: S
authors.lastname: Kische
authors.forename: Lylia
authors.initials: L
authors.lastname: Paranskaya
authors.forename: Henrik
authors.initials: H
authors.lastname: Schneider
authors.forename: Tim C
authors.initials: TC
authors.lastname: Rehders
authors.forename: Ulrich
authors.initials: U
authors.lastname: Trautwein
authors.forename: Gökmen
authors.initials: G
authors.lastname: Turan
authors.forename: Dietmar
authors.initials: D
authors.lastname: Bänsch
authors.forename: Olga
authors.initials: O
authors.lastname: Thiele
authors.forename: Dimitar
authors.initials: D
authors.lastname: Divchev
authors.forename: Ilkay
authors.initials: I
authors.lastname: Bozdag-Turan
authors.forename: Jasmin
authors.initials: J
authors.lastname: Ortak
authors.forename: Gunther
authors.initials: G
authors.lastname: Kundt
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012189:Retrospective Studies