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Evaluation of the incidence, timing, and potential recovery rates of complete atrioventricular block after transcatheter aortic valve implantation: a Japanese multicenter registry study.
Cardiovasc Interv Ther. 2021 Apr; 36(2):246-255.CI

Abstract

Data on the accurate onset date and serial changes of the complete atrioventricular block (CAVB) after transcatheter aortic valve implantation (TAVI) are limited. This study aimed to assess the incidence, timing, and potential recovery of CAVB following TAVI. Total 696 patients who underwent TAVI were enrolled. Acute CAVB was evaluated within 24 h; delayed CAVB was evaluated 24 h after TAVI. Recovered CAVB was defined as ventricular pacing < 1% during the follow-up or transit block without the need for permanent pacemaker implantation (PMI). The other patients with CAVB were categorized as continued CAVB. Clinical differences between the recovered and continued CAVB groups were evaluated, and the predictive factors of continued CAVB were assessed. The incidence rates of CAVB, acute CAVB, and delayed CAVB were 6.9% (48/696), 4.6% (32/696), and 2.3% (16/696), respectively. Overall, 47.9% (23/48) of patients had recovered CAVB, which was more prevalent in the acute CAVB group than in the delayed CAVB group [59.4% (19/32) vs. 25.0% (4/16), p = 0.025]. CAVB recovery occurred within 24 h (61.0%, 14/23) and after 24 h (39.0%, 9/23). Before CAVB recovery, 21.7% (5/23) of patients had already undergone PMI. A pre-existing complete right bundle branch block (CRBBB) was the only independent predictive factor of continued CAVB (odds ratio 4.51, 95% confidence interval 1.03-19.6, p = 0.045). In conclusion, a pre-existing CRBBB and the timing and prolonged duration of CAVB may be used in risk stratification to determine the appropriateness of early discharge, optimal PMI date, and PMI indication.

Authors+Show Affiliations

Department of Cardiology, Toyohashi Heart Canter, 21-1 Gobudori, Oyamachyo, Toyohashi, Aichi, 441-8530, Japan.Department of Cardiology, Toyohashi Heart Canter, 21-1 Gobudori, Oyamachyo, Toyohashi, Aichi, 441-8530, Japan. yamamoto@heart-center.or.jp. Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan. yamamoto@heart-center.or.jp.Department of Cardiology, Toyohashi Heart Canter, 21-1 Gobudori, Oyamachyo, Toyohashi, Aichi, 441-8530, Japan.Department of Cardiology, Toyohashi Heart Canter, 21-1 Gobudori, Oyamachyo, Toyohashi, Aichi, 441-8530, Japan.Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan.Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan.Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan.Department of Cardiology, New Tokyo Hospital, Chiba, Japan.Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan.Department of Cardiology, Syonan Kamakura General Hospital, Kanagawa, Japan.Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan.Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32418052

Citation

Kagase, Ai, et al. "Evaluation of the Incidence, Timing, and Potential Recovery Rates of Complete Atrioventricular Block After Transcatheter Aortic Valve Implantation: a Japanese Multicenter Registry Study." Cardiovascular Intervention and Therapeutics, vol. 36, no. 2, 2021, pp. 246-255.
Kagase A, Yamamoto M, Shimura T, et al. Evaluation of the incidence, timing, and potential recovery rates of complete atrioventricular block after transcatheter aortic valve implantation: a Japanese multicenter registry study. Cardiovasc Interv Ther. 2021;36(2):246-255.
Kagase, A., Yamamoto, M., Shimura, T., Kodama, A., Kano, S., Koyama, Y., Tada, N., Takagi, K., Araki, M., Yamanaka, F., Shirai, S., Watanabe, Y., & Hayashida, K. (2021). Evaluation of the incidence, timing, and potential recovery rates of complete atrioventricular block after transcatheter aortic valve implantation: a Japanese multicenter registry study. Cardiovascular Intervention and Therapeutics, 36(2), 246-255. https://doi.org/10.1007/s12928-020-00670-6
Kagase A, et al. Evaluation of the Incidence, Timing, and Potential Recovery Rates of Complete Atrioventricular Block After Transcatheter Aortic Valve Implantation: a Japanese Multicenter Registry Study. Cardiovasc Interv Ther. 2021;36(2):246-255. PubMed PMID: 32418052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the incidence, timing, and potential recovery rates of complete atrioventricular block after transcatheter aortic valve implantation: a Japanese multicenter registry study. AU - Kagase,Ai, AU - Yamamoto,Masanori, AU - Shimura,Tetsuro, AU - Kodama,Atsuko, AU - Kano,Seiji, AU - Koyama,Yutaka, AU - Tada,Norio, AU - Takagi,Kensuke, AU - Araki,Motoharu, AU - Yamanaka,Futoshi, AU - Shirai,Shinichi, AU - Watanabe,Yusuke, AU - Hayashida,Kentaro, Y1 - 2020/05/16/ PY - 2019/06/18/received PY - 2020/05/04/accepted PY - 2020/5/18/pubmed PY - 2021/6/29/medline PY - 2020/5/18/entrez KW - Complete atrioventricular block KW - Pacemaker KW - Transcatheter aortic valve implantation SP - 246 EP - 255 JF - Cardiovascular intervention and therapeutics JO - Cardiovasc Interv Ther VL - 36 IS - 2 N2 - Data on the accurate onset date and serial changes of the complete atrioventricular block (CAVB) after transcatheter aortic valve implantation (TAVI) are limited. This study aimed to assess the incidence, timing, and potential recovery of CAVB following TAVI. Total 696 patients who underwent TAVI were enrolled. Acute CAVB was evaluated within 24 h; delayed CAVB was evaluated 24 h after TAVI. Recovered CAVB was defined as ventricular pacing < 1% during the follow-up or transit block without the need for permanent pacemaker implantation (PMI). The other patients with CAVB were categorized as continued CAVB. Clinical differences between the recovered and continued CAVB groups were evaluated, and the predictive factors of continued CAVB were assessed. The incidence rates of CAVB, acute CAVB, and delayed CAVB were 6.9% (48/696), 4.6% (32/696), and 2.3% (16/696), respectively. Overall, 47.9% (23/48) of patients had recovered CAVB, which was more prevalent in the acute CAVB group than in the delayed CAVB group [59.4% (19/32) vs. 25.0% (4/16), p = 0.025]. CAVB recovery occurred within 24 h (61.0%, 14/23) and after 24 h (39.0%, 9/23). Before CAVB recovery, 21.7% (5/23) of patients had already undergone PMI. A pre-existing complete right bundle branch block (CRBBB) was the only independent predictive factor of continued CAVB (odds ratio 4.51, 95% confidence interval 1.03-19.6, p = 0.045). In conclusion, a pre-existing CRBBB and the timing and prolonged duration of CAVB may be used in risk stratification to determine the appropriateness of early discharge, optimal PMI date, and PMI indication. SN - 1868-4297 UR - https://www.unboundmedicine.com/medline/citation/32418052/Evaluation_of_the_incidence_timing_and_potential_recovery_rates_of_complete_atrioventricular_block_after_transcatheter_aortic_valve_implantation:_a_Japanese_multicenter_registry_study_ DB - PRIME DP - Unbound Medicine ER -