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Document Details : Title: Baseline HV-interval predicts complete AV-block secondary to transcatheter aortic valve implantation Author(s): D.-I. Shin , M.W. Merx , C. Meyer , K. Kirmanoglou , K. Hellhammer , J. Ohlig , D. Katsani , T. Zeus , R. Westenfeld , C. Eickholt , A. Linke , M. Kelm Journal: Acta Cardiologica Volume: 70 Issue: 5 Date: 2015 Pages: 574-580 DOI: 10.2143/AC.70.5.3110518 Abstract : Purpose: Development of AV-block is a frequent complication associated with transcatheter aortic valve implantation (TAVI). To date little is known about the predictive value of the HV-interval prior to TAVI with respect to the risk of AV-block development. Methods and results: HV-interval was determined in 25 consecutive elderly patients with severe aortic valve stenosis (AS) before and immediately after TAVI. All patients subsequently underwent TAVI and 8 of these 25 patients (32%) developed complete AV-block during the TAVI procedure requiring permanent pacemaker implantation. Six of these 8 patients (75%) had marked HV prolongation (> 54 ms). Pre-procedural HV-interval was significantly prolonged in the subgroup developing complete AV-block (62.1 ms ± 13.0 vs 49.2 ms ± 12.9; P = 0.029). Prolongation of the HV-interval above 54 ms was associated with a higher rate of complete AV-block (sensitivity 75.0%, specificity 77.8%, P = 0.01). Conclusions: HV-interval was prolonged in approximately one third of our elderly patients with aortic valve stenosis and associated with a high rate of complete AV-block following TAVI. HV-interval is easily obtained during TAVI screening procedures, thus facilitating identification of patients at risk for complete AV-block due to TAVI and consequently enabling bespoke risk management. |
