Pacemaker Dependence After Transcatheter Aortic Valve Implantation

Mustafa Yildiz1, Banu Sahin Yildiz2, Ibrahim Akin3

1. Interventional Cardiology Consultant, Institute of Cardiology, Istanbul University, Haseki Caddesi 29-32, 34096 Istanbul, Turkey
2. Internal Medicine Consultant, Department of Internal Medicine, Dr Lutfi Kartal Educational and Research Hospital, Istanbul, Turkey
3. Interventional Cardiology Consultant, Heart Center Rostock, Department of Internal Medicine I, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany

Disclosure: No potential conflict of interest.
Citation: EMJ Int Cardiol. 2013;1:92-97.

Abstract

Transcatheter aortic valve implantation has been emerged as an alternative for multimorbide patients not suitable for open-heart surgery. The vicinity of the conduction system, especially the atrioventricular node and His bundle to the non-coronary and right-coronary aortic cusp predispose these patients to conduction abnormalities. However, due to the shape of both available transcatheter aortic valves (CoreValve, Edwards Sapien valve) these rates are different. To date there is no clear information about the true rate of atrioventricular block, the significance of left bundle branch block as well as the transient or permanent nature of these conduction disorders. Due to this the rate of subsequent pacemaker-implantation exceeds up to 50%, which itself may be associated with worse clinical outcomes. Thus, there is a need for further data from large-scale series with a glance to the true rate of clinical relevant conduction disorders.

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