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Predictors of pacemaker implantation after transcatheter aortic valve implantation

Authors: Dzhidzalova D.Kh., Berdibekov B.Sh., Bulaeva N.I., Petrosian K.V., Mrikaev D.V., Kudryashova E.N., Efendieva A.S., Abgaryan A.A., Romanchuk D.V., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2023-17-4-525-535

For citation: Dzhidzalova D.Kh., Berdibekov B.Sh., Bulaeva N.I., Petrosian K.V., Mrikaev D.V., Kudryashova E.N., Efendieva A.S., Abgaryan A.A., Romanchuk D.V., Golukhova E.Z. Predictors of pacemaker implantation after transcatheter aortic valve implantation. Creative Cardiology. 2023; 17 (4): 525–35 (in Russ.). DOI: 10.24022/1997-3187-2023-17-4-525-535

Received / Accepted:  10.11.2023 / 20.11.2023

Keywords: aortic stenosis transcatheter aortic valve implantation pacemaker right bundle branch block atrioventricular block



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Abstract

Objective. To assess the incidence of cardiac conduction disorders associated with transcatheter aortic valve implantation (TAVI) and identification of predictors of the need for permanent cardiac pacing (PCP) in the early postoperative period.

Material and methods. A prospective single-center study included 70 patients with symptomatic severe aortic stenosis who underwent the procedure TAVI. The average age of the patients was 75.1±6.8 years, most of them were women (67.1%). To determine cardiac conduction disorders all patients underwent electrocardiogram registration before and after TAVI. Univariate and multivariate regression analyzes were used to determine the factors influencing the need for PCP after TAVI.

Results. Statistically significant prolongation of the duration of the QRS complex (p=0.009) and QT (p=0.026) after TAVI was established as a result of the analysis. Third degree atrioventricular block was significantly more common (0.0 versus 2.9%, р=0.031) in the postoperative period, therefore the need for pacemaker implantation occurred more often (4.3 versus 14.3%, р=0.0016). Predictors such as female sex, left ventricular (LV) ejection fraction, LV end-diastolic volume, LV end-systolic volume, prolongation of PQ intervals and QRS duration, and baseline right bundle branch block (RBBB) by univariate regression analysis were associated with pacemaker implantation after TAVI during the hospital period. As a result of multivariate regression analysis, the independent predictor associated with pacemaker implantation during the hospital period after TAVI was the presence of RBBB (odds ratio 11.38; 95% confidence interval 1.13–114.08; p=0.039).

Conclusion. As a result of the study, it was revealed that the only independent predictor of PCP after TAVI in the hospital period is the presence of initial RBBB.

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About Authors

  • Diana Kh. Dzhidzalova, Cardiologist; ORCID
  • Bektur Sh. Berdibekov, Junior Researcher, Cardiologist; ORCID
  • Naida I. Bulaeva, Cand. Biol. Sci., Associate Professor, Head of Department, Cardiologist; ORCID
  • Karen V. Petrosian, Dr. Med. Sci., Endovascular Surgeon, Head of Department; ORCID
  • David V. Mrikaev, Cand. Med. Sci., Cardiologist; ORCID
  • Elena N. Kudryashova, Cardiologist; ORCID
  • Anastasiya S. Efendieva, Postgraduate; ORCID
  • Anna A. Abgaryan, Postgraduate; ORCID
  • Denis V. Romanchuk, Postgraduate; ORCID
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of RAS, Director; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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