TY  - BOOK
AU  - Barbash, Israel M
AU  - Ben-Dor, Itsik
AU  - Hauville, Camille
AU  - Laynez-Carnicero, Ana
AU  - Lindsay, Joseph
AU  - Maluenda, Gabriel
AU  - Pichard, Augusto D
AU  - Sardi, Gabriel L
AU  - Satler, Lowell F
AU  - Waksman, Ron
AU  - Xue, Zhenyi
TI  - Frequency of conduction disturbances after Edwards SAPIEN percutaneous valve implantation
SN  - 0002-9149
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Atrioventricular Block/ep [Epidemiology]
KW  - *Atrioventricular Block/th [Therapy]
KW  - *Bundle-Branch Block/ep [Epidemiology]
KW  - *Bundle-Branch Block/th [Therapy]
KW  - *Heart Valve Prosthesis
KW  - *Pacemaker, Artificial
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - *Postoperative Complications/th [Therapy]
KW  - Cardiac Catheterization
KW  - Chi-Square Distribution
KW  - Coronary Angiography
KW  - Echocardiography
KW  - Electrocardiography
KW  - Female
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Prospective Studies
KW  - Registries
KW  - Statistics, Nonparametric
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - Disturbances in atrioventricular conduction and the additional need for a permanent pacemaker are recognized complications after transcatheter aortic valve replacement (TAVR). We analyzed the incidence of postprocedural conduction disorders and the need for permanent pacemaker implantation in patients undergoing TAVR with the Edwards SAPIEN valve. In 125 consecutive patients with symptomatic, severe aortic stenosis undergoing TAVR, a standard 12-lead electrocardiogram was obtained before and serially after the procedure. The cohort was divided into 2 groups with regard to the post-TAVR appearance of conduction disturbances, defined as left bundle branch block, right bundle branch block, fascicular hemiblock, atrioventricular block, and the need for a permanent pacemaker. The patients with and without conduction disturbances were compared. After TAVR, 19 patients (15.2%) met the study definition of a "new conduction defect" and 5 patients (4%) required a permanent pacemaker because of an advanced atrioventricular block. New left bundle branch block appeared in 5 patients (4%) and left anterior hemiblock in 9 (7.2%). No new right bundle branch block or left posterior hemiblock was observed. Although most baseline, echocardiographic, and procedural characteristics were equally distributed, the patients with new conduction disturbances more often had diabetes mellitus and peripheral vascular disease. Also, they more often were taking an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, and the procedure was performed more often with apical access (12 [63.2%] vs 7 with femoral access [36.8%], p = 0.002). In conclusion, although the incidence of conduction disturbances was high after TAVR using the Edwards SAPIEN valve, with a significant increase in the rate of left bundle branch block and left anterior hemiblock, the need for permanent pacemaker implantation after TAVR with this valve remained low. Copyright  2012 Elsevier Inc. All rights reserved
UR  - http://dx.doi.org/10.1016/j.amjcard.2012.05.057
ER  -