In:
Europace, Oxford University Press (OUP)
Abstract:
Conduction abnormalities post transcatheter aortic valve implantation (TAVI) are common. Post-TAVI PR prolongation was mainly studied as an adjunct to new-onset bundle branch block. The net effect of isolated PR prolongation (IPRP) without post-TAVI QRS changes is not well known. Aims To define the incidence and clinical significance of post-TAVI IPRP. Methods 1108 consecutive TAVI patients were reviewed. Patients with IPRP were compared to patients without post-TAVI ECG changes. Clinical outcomes included permanent pacemaker implantation (PPI) and overall mortality. Results 146 patients with IPRP were compared to 290 patients without post-TAVI ECG changes. At 1-year follow-up, 4(2.7%) and 7(2.4%) patients underwent PPI (p=0.838) and 10(6.8%) and 25(8.6%) died (p=0.521), from the study and control group, respectively. No patient with IPRP and narrow QRS underwent PPI during 1-year post-TAVI and all death events were non-cardiac except 1 unknown cause. PPI rates among patients with IPRP and wide QRS were higher (n=4, 12.1%), compared to patients with wide QRS without post-TAVI ECG change (n=3, 4%), however not reaching statistical significance (p=0.126). Multivariate Cox proportional-hazards model demonstrated that in patients with narrow QRS, neither PR prolongation nor baseline or maximal PR intervals were associated with the combined endpoint of PPI and mortality. However, in patients with wide QRS, baseline PR intervals and QRS width, but not PR prolongation were associated with the combined outcome. Conclusions Post-TAVI IPRP in patients with narrow QRS is not associated with adverse outcome. This finding may translate clinically into a more permissive approach to these patients.
Type of Medium:
Online Resource
ISSN:
1099-5129
,
1532-2092
DOI:
10.1093/europace/euae011
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2024
detail.hit.zdb_id:
2002579-8
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