title: Pathophysiology, incidence and predictors of conduction disturbances during Transcatheter Aortic Valve Implantation.
abstract: Over the past decade, transcatheter aortic valve implantation (TAVI) has evolved rapidly toward an extremely reproducible, safe and effective procedure, with a marked reduction of its related complications. However, the occurrence of conduction disturbances and the need for permanent pacemaker implantation (PPI) after TAVI remains a concern. Areas covered: In this article review, we will go through the mechanisms involved in conduction disturbances after TAVI, and we will discuss the key aspects of pathophysiology, incidence and predictors of conduction disturbances following Transcatheter Aortic Valve Implantation. The evaluation of patient's valve anatomy and the selection of the most appropriate prosthesis have been proposed as a valuable options to reduce the incidence of conductions disturbances. Moreover, in recent times, a great number of new TAVI devices, so-called 'second-generation devices', have been introduced to address the limitations of the first-generation devices, including conduction disturbance, with scarce results. Expert commentary: Conduction disturbances after TAVI are increasingly recognized as an important issue in TAVI complications. Further characterization of the procedural- and patient-related factors that contribute to the development of conduction abnormalities will help to improve prosthesis designs and patient selection, making TAVI even more safer.
authors.affiliation: a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.affiliation: a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Gulino
authors.affiliation: a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Costa
authors.affiliation: a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D001021:Aortic Valve / Q000473:pathology; D003362:Cost-Benefit Analysis; D006329:Heart Conduction System / Q000503:physiopathology*; D006350:Heart Valve Prosthesis / Q000191:economics; D006801:Humans; D015994:Incidence; D010138:Pacemaker, Artificial; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000191:economics
keywords: Aortic; TAVI; TAVR; atrio-ventricular block; conduction disturbances; left bundle branch block; pacemaker