title: Baseline HV-interval predicts complete AV-block secondary to transcatheter aortic valve implantation.
abstract: OBJECTIVE
  Development of AV-block is a frequent complication associated with transcatheter aortic valve implantation (TAVI). To date little is known about the predictive value of the HV-interval prior to TAVI with respect to the risk of AV-block development.
  
  
  RESULTS
  HV-interval was determined in 25 consecutive elderly patients with severe aortic valve stenosis (AS) before and immediately after TAVI. All patients subsequently underwent TAVI and 8 of these 25 patients (32%) developed complete AV-block during the TAVI procedure requiring permanent pacemaker implantation. Six of these 8 patients (75%) had marked HV prolongation (>54 ms). Pre-procedural HV-interval was significantly prolonged in the subgroup developing complete AV-block (62.1 ms±13.0 vs 49.2 ms±12.9; P=0.029). Prolongation of the HV-interval above 54 ms was associated with a higher rate of complete AV-block (sensitivity 75.0%, specificity 77.8%, P=0.01).
  
  
  CONCLUSIONS
  HV-interval was prolonged in approximately one third of our elderly patients with aortic valve stenosis and associated with a high rate of complete AV-block following TAVI. HV-interval is easily obtained during TAVI screening procedures, thus facilitating identification of patients at risk for complete AV-block due to TAVI and consequently enabling bespoke risk management.
authors.forename: Dong-In
authors.initials: DI
authors.lastname: Shin
authors.forename: Marc W
authors.initials: MW
authors.lastname: Merx
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Kirmanoglou
authors.forename: Katharina
authors.initials: K
authors.lastname: Hellhammer
authors.forename: Jan
authors.initials: J
authors.lastname: Ohlig
authors.forename: Dimitra
authors.initials: D
authors.lastname: Katsani
authors.forename: Tobias
authors.initials: T
authors.lastname: Zeus
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.forename: Christian
authors.initials: C
authors.lastname: Eickholt
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002304:Cardiac Pacing, Artificial; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: CoreValve; HV-interval; TAVI; aortic valve disease; complete AV-block; permanent pacemaker