Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation

Version 1 : Received: 29 November 2023 / Approved: 30 November 2023 / Online: 30 November 2023 (04:15:25 CET)

A peer-reviewed article of this Preprint also exists.

Damas, F.; Nguyen Trung, M.-L.; Postolache, A.; Petitjean, H.; Lempereur, M.; Viva, T.; Oury, C.; Dulgheru, R.; Lancellotti, P. Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation. J. Clin. Med. 2024, 13, 409. Damas, F.; Nguyen Trung, M.-L.; Postolache, A.; Petitjean, H.; Lempereur, M.; Viva, T.; Oury, C.; Dulgheru, R.; Lancellotti, P. Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation. J. Clin. Med. 2024, 13, 409.

Abstract

To evaluate whether the extent of cardiac damage in severe aortic stenosis (AS) might be associated with the occurrence of conduction system disorders after TAVI. A total of 153 symptomatic patients with severe AS who had a TAVI were categorized before the procedure according to the extent of cardiac damage: stage 1 (13.5%): no or LV damage; stage 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); stage 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-AVD whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with resolutive 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). No patient in group 1 died during the hospital stay. In conclusion, cardiac damage staging of AS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.

Keywords

TAVI; Cardiac damage; conduction disorders; risk stratification

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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