[Cardiac permanent pacemaker after transcatheter aortic valve implantation: A predictive and scientific review].
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i.e when that size is inferior to the valve's one) and the QRS duration after the procedure (the superior threshold has been set at 128ms for the Corevalve). The currently recommendations advice to implant a pacemaker are as followed: high grade AV block (in the main studies, the implantation occurs within the 5 days after the TAVI), complete and transient AV block during the TAVI, second degree AV block and RBBB associated with first degree AV block. Our article aims to review the arrhythmic issues of TAVI.
Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France; Service de cardiologie, centre hospitalier de Melun, 2, rue Fréteau-de-Peny, 77011 Melun cedex, France.
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Moini
Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France.
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Sidia
Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France.
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Poindron
Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France.
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Fiorina
Unité de chirurgie cardiaque, hôpital Jacques-Cartier, 6, avenue du Noyer-Lambert, 91300 Massy, France.
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Farge
Unité de rythmologie, GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
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Amara
Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France. Electronic address: meidi.elissa@yahoo.fr.
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El Issa
D001024:Aortic Valve Stenosis / Q000628:therapy*; D003131:Combined Modality Therapy; D019983:Guideline Adherence; D006327:Heart Block / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011379:Prognosis; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*
Conductive disturbances; CoreValve(®); Facteurs prédictifs; Pacemaker; Predictive factors; TAVI; Troubles conductifs; Valve Edwards Sapien(®)