Conductive disturbances in the transcatheter aortic valve implantation setting: An appraisal of current knowledge and unmet needs - 02/09/23
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Graphical abstract |
Highlights |
• | NOCDs are associated with a poorer prognosis after TAVI. |
• | Risk assessment is usually limited to evaluation of baseline electrocardiogram. |
• | Computed tomography provides additional valuable insights for risk assessment. |
• | Implantation depth can be optimized using the cusp-overlap projection. |
• | Electrophysiology study allows safe discharge in patients with HV interval<70ms. |
• | Ambulatory electrocardiogram monitoring is safe and effective to identify HAVB. |
Abstract |
New-onset conduction disturbances, including left bundle branch block and permanent pacemaker implantation, remain a major issue after transcatheter aortic valve implantation. Preprocedural risk assessment in current practice is most often limited to evaluation of the baseline electrocardiogram, whereas it may benefit from a multimodal approach, including ambulatory electrocardiogram monitoring and multidetector computed tomography. Physicians may encounter equivocal situations during the hospital phase, and the management of follow-up is not fully defined, despite the publication of several expert consensuses and the inclusion of recommendations regarding the role of electrophysiology studies and postprocedural monitoring in recent guidelines. This review provides an overview of current knowledge and future perspectives regarding the management of new-onset conduction disturbances in the setting of transcatheter aortic valve implantation, from the preprocedural phase to long-term follow-up.
Le texte complet de cet article est disponible en PDF.Keywords : Transcatheter aortic valve repair, New-onset conduction disturbances, Left bundle branch block, Permanent pacemaker implantation, High-degree atrioventricular block
Abbreviations : CI, CRT, HAVB, LBBB, LVEF, MSL, NOCD, PPI, RBBB, SAVR, TAVI, THV
Plan
☆ | Tweet: a narrative review of conduction disturbances among transcatheter aortic valve implantation candidates and recipients. |
Vol 116 - N° 8-9
P. 419-425 - août 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.