Transcatheter aortic valve replacement (TAVR) has shown remarkable benefits and continues to advance towards lower-risk patients and younger ages. However, one of its limitations lies in the demand for a permanent pacemaker (PPM), which during TAVR early stages with self-expanding valves reached 30%. Uncertainty persists regarding the evolution of patients undergoing PPM implantation after TAVR,...
Permanent pacemaker implantation (PPI) is a relevant complication in patients undergoing transcatheter aortic valve replacement (TAVR) despite there being new devices. The current information on the long term impact of this complication remains unclear and recent evidence suggests post-TAVR ventricular pacing (VP) might be associated to higher risk of all-cause mortality and hospitalization for cardiac...
We are well aware of the benefits of TAVR in different scenarios, but the need for permanent pacemaker implantation (PPI) in self-expandable valves is between 15% and 30% according to different randomized and non-randomized studies. This is why the higher implantation strategy or cusp overlap (COT) was developed and, though it has been shown to...
Alcohol septal ablation is used to treat patients with obstructive hypertrophic cardiomyopathy. A significant complication in this intervention is atrioventricular block requiring pacemaker implantation in 7% to 20% of cases. Current evidence is limited for clinical results at follow-up for these patients. The aim of this study was to evaluate the results for patients with...
One of the main complications of alcohol septal ablation (ASA) is the alteration in the conduction system, which could lead to permanent pacemaker (PPM) implantation. This is mainly due to the relationship between septal perfusion and the conduction system (especially the right bundle branch). The incidence reported in the literature is 7% to 20% of...
Courtesy of Dr. Carlos Fava. As we know, with higher life expectancy comes a significant increase in the use of definite pacemakers, defibrillators and resynchronization devices. Along these lines, the presence of catheters is associated to tricuspid regurgitation, which over time might become severe, leading to cardiac regurgitation and potentially heart failure. This group is...
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial and is constantly being advanced onto lower risk populations, but at present, it is limited (perhaps most importantly in aortic tricuspid valves) by the need for permanent pacemaker implantation (PPMI), especially when it comes to self-expandable valves, as the latest study on low risk populations...
This new consensus published this week in J Am Coll Cardiol has provided us with an algorithm to manage conduction disturbances after transcatheter aortic valve replacement. This consensus is intended to reduce potential deaths caused by conduction disturbances and, at the same time, reduce unnecessary definite pacemaker implantation. This document is a big step ahead...
Delayed high-grade block after transcatheter aortic valve replacement (TAVR) goes unnoticed in patients undergoing TAVR without prior conduction disorders because, most times, it takes place during hospitalization or immediately after the procedure. Right bundle branch block is a risk factor, but it has poor sensitivity for the prediction of high-grade blocks, and there may be...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons. The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with...