![]() It is known that TAVI can induce cardiac electrical disturbances of varying severity. Since the introduction of this technology to clinical practice, more than 300 000 patients have been treated, but these figures are likely to increase dramatically in the future. 3,4 More recently, new randomized trials have broadened the clinical indications for the procedure, demonstrating its efficacy also in intermediate risk 5,6 and low risk 7 patients. 1,2 In the last 10 years, transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective treatment in patients with severe AS considered inoperable or at high surgical risk. A profundidade de implantação da prótese foi preditora de BRE.Īortic stenosis (AS) is the most common primary heart valve disease requiring intervention in Western countries, but its prevalence will increase exponentially due to the population ageing. ![]() Estas alterações foram mais acentuadas nos doentes com próteses autoexpansíveis e houve tendência para a melhoria aos seis meses. ConclusõesĪs principais alterações elétricas cardíacas após a TAVI foram o prolongamento do intervalo PR, aumento do QRS e BRE de novo. A profundidade de implantação da prótese no trato de saída do ventrículo esquerdo foi preditora de BRE à alta pela análise multivariada (OR 37,6, 95% CI 14,6–65,2, p=0,001). Em 25% dos doentes verificou-se bloqueio de ramo esquerdo de novo (BRE). Houve aumento significativo da duração do complexo QRS à alta (129☒8 ms versus 114☒5 p< 0,0001), que persistiu aos seis meses (122☒8 ms, p< 0,0001). Após a TAVI, 21% tiveram fibrilhação auricular de novo e houve aumento significativo do intervalo PR à alta (186±41 ms versus 176☓2 p=0,003), que não persistiu aos seis meses (181☓5 ms, p=0,06). Antes do procedimento, 80% dos doentes estavam em ritmo sinusal. Incluídos 182 doentes (78☘ anos sexo feminino 56%) e em 54% destes implantadas próteses autoexpansíveis. Os doentes com pacemaker permanente foram excluídos. MétodosĪnálise retrospetiva dos electrocardiogramas, antes e após TAVI, num centro terciário entre agosto/2007 e outubro/2016. ObjetivosĪvaliar a frequência e o tipo de alterações elétricas após a TAVI, consoante o tipo de prótese avaliar os preditores destas alterações. Contudo, à exceção do risco de implantação de pacemaker definitivo, poucos estudos avaliaram os efeitos da TAVI nas propriedades elétricas. The depth of valve implantation was a predictor of conduction disturbances.Ī implantação percutânea de prótese aórtica (TAVI) associa-se a alterações da condução elétrica cardíaca. These disturbances were more pronounced in patients undergoing SEP implantation and tended to improve at six-month follow-up. The main electrocardiographic disturbances post TAVI were PR prolongation, increased QRS and new-onset LBBB. The depth of valve implantation was a predictor of new LBBB at discharge after multivariate analysis (OR 37.6, 95% CI 14.6–65.2, p=0.001). New-onset left-bundle branch block (LBBB) was observed in 25% of patients. There was also a significant increase in QRS duration at discharge (129☒8 ms vs. After TAVI, 21% of patients developed new-onset atrial fibrillation and there was a significant increase in PR interval at discharge (186±41 ms vs. Most patients (80%) were in sinus rhythm at baseline. We included 182 patients (78☘ years 56% female) and self-expanding prostheses (SEP) were implanted in 54%. ![]() Patients with permanent pacemakers were excluded. ![]() We performed a detailed retrospective analysis of all electrocardiograms in patients who underwent TAVI, before and after the procedure, at a tertiary center from August 2007 to October 2016. To assess the frequency and type of electrocardiographic disturbances following TAVI, according to the type of prostheses and to assess predictors of these disturbances. However, beyond the risks of pacemaker implantation, few studies have performed a detailed assessment of the effects of TAVI on several cardiac electrical properties. Transcatheter aortic valve implantation (TAVI) is associated with cardiac electrical disturbances. ![]()
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