title: One-year follow-up of conduction disturbances following transcatheter aortic valve implantation.
abstract: OBJECTIVE
  To describe the postprocedural and 1-year follow-up incidence of heart conduction disturbances in patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  Ninety-five patients were enrolled from 2008 to 2011 (mean age 81.8 ± 7.2 years, 63.1% women). Clinical and ECG data were recorded at admission, discharge, and 3, 6 and 12 months following TAVI.
  
  
  RESULTS
  Fifty-seven Edwards SAPIEN (31 transapical, 26 transfemoral) and 38 transfemoral CoreValve implants were used. Two (2.1%) patients died during the procedure and 11 (11.6%) patients received a pacemaker prior to discharge (7 CoreValve, 3 transapical, 1 transfemoral SAPIEN; P = 0.18). Among the surviving patients not receiving a pacemaker, TAVI increased the PQ interval (176 ± 29 vs. 188 ± 36 ms; P = 0.001), QRS width (90 ± 15 vs. 108 ± 26 ms; P < 0.001), and first-grade atrioventricular block (17 vs. 29%; P < 0.001). Postprocedural complete left bundle branch block was reported most in transapical (from 10 to 36%; P = 0.01) and CoreValve (from 8 to 64%; P < 0.001) recipients compared to the transfemoral SAPIEN group. At the 12-month follow-up, 24 (25.3%) patients had died [two (2.1%) sudden deaths] and four (4.2%) required pacemaker implantation. Among the survivors not receiving a pacemaker at the 1-year follow-up, the PQ interval (178 ± 27 vs. 188 ± 36 ms; P = 0.39) remained unchanged in the ECG, whereas the QRS width (100 ± 22 vs. 108 ± 26 ms; P = 0.008) decreased compared to measurements taken at discharge.
  
  
  CONCLUSIONS
  Conduction disturbances following TAVI primarily develop during hospitalization and subsequently stabilize. However, the small percentage of patients suffering sudden death or pacemaker implantation requires attention.
authors.affiliation: aUniversity of Torino - Department of Surgical Sciences, Division of Cardiac Surgery bUniversity of Torino - Department of Medical Sciences, Division of Cardiology c'Città della Salute e della Scienza' Hospital, Division of Cardiology, Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Salizzoni
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.forename: Cristina
authors.initials: C
authors.lastname: Fornengo
authors.forename: Francesca
authors.initials: F
authors.lastname: Giordana
authors.forename: Michele
authors.initials: M
authors.lastname: La Torre
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'Amico
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedé
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Marra
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D053840:Brugada Syndrome; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D000075224:Cardiac Conduction System Disease; D003645:Death, Sudden; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome