[en] Recently, a staging system using 4 grades has been proposed to quantify the extent of cardiac damage associated with aortic stenosis (AS), namely AS-related cardiac damage staging (ASCDS). ASCDS is independently associated with all-cause mortality and important clinical outcomes. To evaluate whether it might be associated with the occurrence of conduction system disorders after TAVI, a total of 119 symptomatic patients with severe AS who underwent a TAVI were categorized according to ASCDS: group 1 (13.5%): no or LV damage; group 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); group 3 (27.7%): low-flow state, pulmonary vasculature/tricuspid valve/RV damage. After TAVI, 34% of patients exhibited LBBB and 10% high-degree atrioventricular block (HD-AVB). No patient in group 1 developed HD-AVB whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with paroxysmal AF with a higher rate for each group increment (group 1: n = 0, 0%; group 2: n = 11, 15.7%; group 3: n = 10, 30.3%) (p = 0.012). Patients in group 3 had the higher rate of permanent pacemaker implantation (PPMI) (group 1: n = 1, 6.3%; group 2: n = 7, 10%; group 3: n = 9, 27.3%) (p = 0.012). In conclusion, ASCDS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
DAMAS, François ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Nguyen Trung, Mai-Linh ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Postolache, Adriana ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
PETITJEAN, Hélène ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Lempereur, Mathieu ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Viva, Tommaso; Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium. ; Department of Minimally Invasive Cardiac Surgery, University of Milan, 20122 Milan, Italy. ; IRCCS Galeazzi, Sant'Ambrogio Hospital, 20157 Milan, Italy.
Rosseel L. Mylotte D. Cosyns B. Vanhaverbeke M. Zweiker D. Teles R.C. Angerås O. Neylon A. Rudolph T.K. Wykrzykowska J.J. et al. Contemporary European Practice in Transcatheter Aortic Valve Implantation: Results from the 2022 European TAVI Pathway Registry Front. Cardiovasc. Med. 2023 10 1227217 10.3389/fcvm.2023.1227217 37645516
Vahanian A. Beyersdorf F. Praz F. Milojevic M. Baldus S. Bauersachs J. Capodanno D. Conradi L. De Bonis M. De Paulis R. et al. 2021 ESC/EACTS Guidelines for the Management of Valvular Heart Disease Eur. Heart J. 2022 43 561 632 10.1093/eurheartj/ehab395 34453165
Karyofillis P. Kostopoulou A. Thomopoulou S. Habibi M. Livanis E. Karavolias G. Voudris V. Conduction Abnormalities after Transcatheter Aortic Valve Implantation J. Geriatr. Cardiol. JGC 2018 15 105 112 10.11909/j.issn.1671-5411.2018.01.004 29434632
Auffret V. Puri R. Urena M. Chamandi C. Rodriguez-Gabella T. Philippon F. Rodés-Cabau J. Conduction Disturbances after Transcatheter Aortic Valve Replacement Circulation 2017 136 1049 1069 10.1161/CIRCULATIONAHA.117.028352 28893961
Mangieri A. Montalto C. Pagnesi M. Lanzillo G. Demir O. Testa L. Colombo A. Latib A. TAVI and Post Procedural Cardiac Conduction Abnormalities Front. Cardiovasc. Med. 2018 5 85 10.3389/fcvm.2018.00085 30018969
Scarsini R. De Maria G.L. Joseph J. Fan L. Cahill T.J. Kotronias R.A. Burzotta F. Newton J.D. Kharbanda R. Prendergast B. et al. Impact of Complications during Transfemoral Transcatheter Aortic Valve Replacement: How Can They Be Avoided and Managed? J. Am. Heart Assoc. 2019 8 e013801 10.1161/JAHA.119.013801 31522627
Sammour Y. Krishnaswamy A. Kumar A. Puri R. Tarakji K.G. Bazarbashi N. Harb S. Griffin B. Svensson L. Wazni O. et al. Incidence, Predictors, and Implications of Permanent Pacemaker Requirement after Transcatheter Aortic Valve Replacement JACC Cardiovasc. Interv. 2021 14 115 134 10.1016/j.jcin.2020.09.063
Auffret V. Webb J.G. Eltchaninoff H. Muñoz-García A.J. Himbert D. Tamburino C. Nombela-Franco L. Nietlispach F. Morís C. Ruel M. et al. Clinical Impact of Baseline Right Bundle Branch Block in Patients Undergoing Transcatheter Aortic Valve Replacement JACC Cardiovasc. Interv. 2017 10 1564 1574 10.1016/j.jcin.2017.05.030
Van Rosendael P.J. Delgado V. Bax J.J. Pacemaker Implantation Rate after Transcatheter Aortic Valve Implantation with Early and New-Generation Devices: A Systematic Review Eur. Heart J. 2018 39 2003 2013 10.1093/eurheartj/ehx785
Lenders G.D. Collas V. Hernandez J.M. Legrand V. Danenberg H.D. den Heijer P. Rodrigus I.E. Paelinck B.P. Vrints C.J. Bosmans J.M. Depth of Valve Implantation, Conduction Disturbances and Pacemaker Implantation with CoreValve and CoreValve Accutrak System for Transcatheter Aortic Valve Implantation, a Multi-Center Study Int. J. Cardiol. 2014 176 771 775 10.1016/j.ijcard.2014.07.092
Prihadi E.A. Leung M. Vollema E.M. Ng A.C.T. Ajmone Marsan N. Bax J.J. Delgado V. Prevalence and Prognostic Relevance of Ventricular Conduction Disturbances in Patients with Aortic Stenosis Am. J. Cardiol. 2017 120 2226 2232 10.1016/j.amjcard.2017.08.046 29037444
Sebag F.A. Lellouche N. Chaachoui N. Dubois-Rande J.-L. Monin J.-L. Prevalence and Clinical Impact of QRS Duration in Patients with Low-flow/Low-gradient Aortic Stenosis Due to Left Ventricular Systolic Dysfunction Eur. J. Heart Fail. 2014 16 639 647 Available online: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.63 (accessed on 19 November 2023) 10.1002/ejhf.63 24549756
Dhingra R.C. Amat-y-Leon F. Pietras R.J. Wyndham C. Deedwania P.C. Wu D. Denes P. Rosen K.M. Sites of Conduction Disease in Aortic Stenosis: Significance of Valve Gradient and Calcification Ann. Intern. Med. 1977 87 275 280 10.7326/0003-4819-87-3-275 900670
Généreux P. Pibarot P. Redfors B. Mack M.J. Makkar R.R. Jaber W.A. Svensson L.G. Kapadia S. Tuzcu E.M. Thourani V.H. et al. Staging Classification of Aortic Stenosis Based on the Extent of Cardiac Damage Eur. Heart J. 2017 38 3351 3358 10.1093/eurheartj/ehx381 29020232
Tastet L. Tribouilloy C. Maréchaux S. Vollema E.M. Delgado V. Salaun E. Shen M. Capoulade R. Clavel M.-A. Arsenault M. et al. Staging Cardiac Damage in Patients with Asymptomatic Aortic Valve Stenosis J. Am. Coll. Cardiol. 2019 74 550 563 10.1016/j.jacc.2019.04.065 31345430
Viva T. Postolache A. Nguyen Trung M.L. Danthine P. Petitjean H. Bruno V.D. Martinez C. Lempereur M. Guazzi M. Aghezzaf S. et al. A New Integrative Approach Combining Right Heart Catheterization and Echocardiography to Stage Aortic Stenosis-Related Cardiac Damage Front. Cardiovasc. Med. 2023 10 1184308 10.3389/fcvm.2023.1184308
Faroux L. Chen S. Muntané-Carol G. Regueiro A. Philippon F. Sondergaard L. Jørgensen T.H. Lopez-Aguilera J. Kodali S. Leon M. et al. Clinical Impact of Conduction Disturbances in Transcatheter Aortic Valve Replacement Recipients: A Systematic Review and Meta-Analysis Eur. Heart J. 2020 41 2771 2781 10.1093/eurheartj/ehz924
Kim K. Ko Y.-G. Shim C.Y. Ryu J. Lee Y.-J. Seo J. Lee S.-J. Cho I. Hong S.-J. Ahn C.-M. et al. Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes after Transcatheter Aortic Valve Replacement Front. Cardiovasc. Med. 2022 9 893878 10.3389/fcvm.2022.893878
Jørgensen T.H. De Backer O. Gerds T.A. Bieliauskas G. Svendsen J.H. Søndergaard L. Mortality and Heart Failure Hospitalization in Patients with Conduction Abnormalities after Transcatheter Aortic Valve Replacement JACC Cardiovasc. Interv. 2019 12 52 61 10.1016/j.jcin.2018.10.053
Wang B. Mei Z. Ge X. Li Y. Zhou Q. Meng X. An G. Comparison of Outcomes of Self-Expanding versus Balloon-Expandable Valves for Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized and Propensity-Matched Studies BMC Cardiovasc. Disord. 2023 23 382 10.1186/s12872-023-03397-3
Smith C.R. Leon M.B. Mack M.J. Miller D.C. Moses J.W. Svensson L.G. Tuzcu E.M. Webb J.G. Fontana G.P. Makkar R.R. et al. Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients N. Engl. J. Med. 2011 364 2187 2198 10.1056/NEJMoa1103510 21639811
Aladham A. Gada H. Wang Y. Mumtaz M. Sultan I. Mulukutla S. Vora A.N. Incidence of Permanent Pacemaker Implantation Using the Cusp Overlap Technique JACC Cardiovasc. Interv. 2022 15 1006 1008 10.1016/j.jcin.2022.03.005 35512914
Szotek M. Drużbicki Ł. Sabatowski K. Amoroso G.R. Schouwer K.D. Matusik P.T. Transcatheter Aortic Valve Implantation and Cardiac Conduction Abnormalities: Prevalence, Risk Factors and Management J. Clin. Med. 2023 12 6056 10.3390/jcm12186056 37762995
Regueiro A. Abdul-Jawad Altisent O. Del Trigo M. Campelo-Parada F. Puri R. Urena M. Philippon F. Rodés-Cabau J. Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Circ. Cardiovasc. Interv. 2016 9 e003635 10.1161/CIRCINTERVENTIONS.115.003635 27169577
Wang J. Liu S. Han X. Chen Y. Chen H. Wan Z. Song B. Prognostic Outcome of New-Onset Left Bundle Branch Block after Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis: A Systematic Review and Meta-Analysis Front. Cardiovasc. Med. 2022 9 842929 10.3389/fcvm.2022.842929
Chamandi C. Barbanti M. Munoz-Garcia A. Latib A. Nombela-Franco L. Gutiérrez-Ibanez E. Veiga-Fernandez G. Cheema A.N. Cruz-Gonzalez I. Serra V. et al. Long-Term Outcomes in Patients with New-Onset Persistent Left Bundle Branch Block Following TAVR JACC Cardiovasc. Interv. 2019 12 1175 1184 10.1016/j.jcin.2019.03.025
Avvedimento M. Franzone A. Leone A. Piccolo R. Castiello D.S. Ilardi F. Mariani A. Esposito R. Iapicca C. Angellotti D. et al. Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation J. Clin. Med. 2021 10 4563 10.3390/jcm10194563
Pellegrini C. Duesmann C. Rheude T. Berg A. Alvarez-Covarrubias H.A. Trenkwalder T. Mayr N.P. Schürmann F. Nicol P. Xhepa E. et al. The Impact of Extra-Valvular Cardiac Damage on Mid-Term Clinical Outcome Following Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis Front. Cardiovasc. Med. 2022 9 1039208 10.3389/fcvm.2022.1039208
Mills R.W. Wright A.T. Narayan S.M. McCulloch A.D. The Effects of Wall Stretch on Ventricular Conduction and Refractoriness in the Whole Heart Cardiac Mechano-Electric Coupling and Arrhythmias Kohl P. Sachs F. Franz M.R. Oxford University Press Oxford, UK 2011 978-0-19-957016-4