Yazarlar |
Zeki Çetinkaya
Elazig Fethi Sekin City Hospital, Turkey |
Deniz Elçik
Erciyes University, Faculty of Medicine, Turkey |
Şaban Keleşoğlu
Erciyes University, Faculty of Medicine, Turkey |
Burak Cesur
Kayseri State Hospital, Turkey |
Mustafa Yaşan
Kastamonu Training and Research Hospital, Turkey |
Uğur Karabiyik
Nigde Training and Research Hospital, Turkey |
Bilge Bingöl
Kırşehir Training and Research Hospital, Turkey |
Nihat Kalay
Erciyes University, Faculty of Medicine, Turkey |
Ramazan Topsakal
Erciyes University, Faculty of Medicine, Turkey |
Aydin Tunçay
Erciyes Üniversitesi, Turkey |
Ali Doğan
Erciyes University, Faculty of Medicine, Turkey |
Mehmet Tuğrul Inanç
Erciyes University, Faculty of Medicine, Turkey |
Özet |
Background/aim: Despite advancements in valve technology and increased clinical experience, complications related to conduction defects after transcatheter aortic valve implantation (TAVR) have not improved as rapidly as expected. In this study, we aimed to predict the development of complete atrioventricular (AV) block and bundle branch block during and after the TAVR procedure and to investigate any changes in the cardiac conduction system before and after the procedure using electrophysiological study. Materials and methods: A total of 30 patients who were scheduled for TAVR at our cardiovascular council were planned to be included in the study. TAVR was performed on patients at Erciyes University Medical Faculty Hospital as a single center between May 2019 and August 2020 Diagnostic electrophysiological study was performed before the TAVR procedure and after its completion. Changes in the cardiac conduction system during the preprocedure, intra-procedure, and postprocedure periods were recorded. Results: Significant increases in baseline cycle length, atrial-His (AH) interval, his-ventricular (HV) interval and atrioventricular (AV) distance were observed before and after the TAVR procedure (p = 0.039, p < 0.001, p = 0.018, p < 0.001, respectively). During the TAVR procedure, the preprocedural HV interval was longer in patients who developed AV block and bundle branch block compared to those who did not and this difference was statistically significant (p = 0.024). ROC curve analysis revealed that a TAVR preprocedure HV value >59.5 ms had 86% specificity and 75% sensitivity in detecting AV block and bundle branch block (AUC = 0.83, 95% CI: 0.664–0.996, p = 0.013). The preprocedure HV distance was 98 ± 10.55ms in the group with permanent pacemaker implantation and the mean value in the group without permanent pacemaker implantation was 66.27 ± 15.55 ms, showing a borderline significant difference (p = 0.049). Conclusion: The prolongation of HV interval in patients with AV block and bundle branch block suggests that the block predominantly occurs at the infra-hisian level. Patients with longer preprocedural HV intervals should be closely monitored for the need for permanent pacemaker implantation after the TAVR procedure. |
Anahtar Kelimeler |
atrial-his interval | AV block | bundle branch block | Transcatheter aortic valve implantation |
Makale Türü | Özgün Makale |
Makale Alt Türü | SCOPUS dergilerinde yayımlanan tam makale |
Dergi Adı | Turkish Journal of Medical Sciences |
Dergi ISSN | 1300-0144 |
Makale Dili | İngilizce |
Basım Tarihi | 01-2023 |
Cilt No | 53 |
Sayı | 6 |
Sayfalar | 1799 / 1806 |
Doi Numarası | 10.55730/1300-0144.5750 |