Conference Proceeding - Restricted Access
Journal of the American College of Cardiology
Background: Transcatheter aortic valve replacement (TAVR) is known to cause conduction abnormalities. However, the impact of TAVR related conduction abnormalities on cardiac implantable electronic device (CIED) parameters in patients with preexisting devices is not known.
Methods: We retrospectively reviewed patients with pre-existing CIEDs who underwent TAVR at a tertiary care center from 2012-2020. We sought to investigate changes in EKG and CIED parameters following TAVR. Continuous variables were reported as mean (± SD). Paired T-test was used to compare various EKG and device parameters pre and post TAVR.
Results: Of the 113 patients studied, median time of device interrogation pre and post TAVR was 50 and 1 day respectively. There was an increase in QRS duration (mean 8.38ms ± 32.2) and QTc interval (mean 14.46ms ± 42.5), increase in right ventricular (RV) pacing (mean 5.86% ± 17.7) and RV threshold (mean 0.14V ± 0.4) and decrease in RV impedance (mean 35.55Ω ± 72.5) post TAVR. Results of paired T-test are shown in Table 1A. Seven patients (6.2%) experienced increase in right ventricular sensing burden from <40% pre-TAVR to >40% post TAVR (mean 51.4 ± 26.9). Seven patients underwent repeat device procedures within 1 year (median 131 days). Table 1B
Conclusion: There are significant electrocardiographic and device parameters changes In patients with preexisting CIEDs who undergo TAVR. Incorporating routine post TAVR device interrogation would lead to early detection of clinically meaningful changes
Madanat L, Seeley E, Shah K, Hanes DE, Mehta N. Changes in baseline EKG and cardiac implantable electronic device parameters following transcatheter aortic valve replacement. J Am Coll Cardiol. 2022 Mar 8;79(9 Suppl): 224.