title: [New conduction disturbances and pacemaker indications after CoreValve® transcatheter aortic valve replacement. Incidence and follow up in a single center experience].
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) is currently reserved for patients with symptomatic aortic stenosis and high surgical risk. One major limiting factor related to TAVI procedural complications is conduction abnormalities and the need for permanent pacemaker implantation.
  
  
  OBJECTIVE
  Evaluate the incidence of new conduction disturbances and pacemaker indications in patients with TAVI CoreValve® prosthesis (Medtronic Inc. Minneapolis, Minnesota, United States).
  
  
  METHODS
  We included 28 patients, mean age 80 years. ECG parameters were evaluated previous and after implantation. All patients were monitorized during TAVI. Follow up Holter monitoring was performed at one, 6 and 12 months after the procedure and we also evaluated telemetry of implanted pacemaker.
  
  
  RESULTS
  In previous ECG we found 7 patients had right bundle branch block and 7 patients had left bundle brunch block (LBBB). The post implant ECG showed 7 new LBBB: 3 during valvuloplasty and 4 on the end of it. Six patients required pacemaker implantation for permanent or paroxysmal complete AV block (CAVB). At one year follow up, 3 patients with LBBB during valvuloplasty had a normal ECG, one still had LBBB and one an asymptomatic CAVB found in Holter monitoring.
  
  
  CONCLUSIONS
  Conduction abnormalities are frequent after CoreValve® aortic valve prosthesis implantation. The incidence of new LBBB was 25%. CAVB during or post TAVI require PM implantation. New LBBB may need a closer follow up because in a 3% of the cases it may progress to CAVB.
authors.affiliation: Servicio de Cardiología, Hospital Fernández, Buenos Aires, Argentina. Electronic address: eliana_aversa@yahoo.com.
authors.forename: Eliana
authors.initials: E
authors.lastname: Aversa
authors.affiliation: Servicio de Cardiología, Hospital Fernández, Buenos Aires, Argentina.
authors.forename: Claudio A
authors.initials: CA
authors.lastname: Muratore
authors.affiliation: Servicio de Cardiología, Hospital Fernández, Buenos Aires, Argentina.
authors.forename: M Laura
authors.initials: ML
authors.lastname: Nemesio
authors.affiliation: Servicio de Cardiología, Hospital Fernández, Buenos Aires, Argentina.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Tentori
authors.affiliation: Servicio de Cardiología, Hospital Fernández, Buenos Aires, Argentina.
authors.forename: Miguel
authors.initials: M
authors.lastname: Payaslian
mesh_terms: D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D011474:Prosthesis Design; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: Aortic stenosis; CoreValve®; Estenosis aórtica; Indicaciones de marcapasos; New conduction disturbances; Nuevos trastornos de conducción; Pacemaker indications; Transcatheter aortic valve implantation; Válvula aórtica percutánea