The most common consequence of transcatheter aortic valve implantation (TAVI) was the new-onset left bundle branch block (NLBBB). In these patients, a consensus of experts supported a temporary transvenous pacemaker (TTVP) for 24 hours. For a study, researchers sought to evaluate TTVP usage in TAVI patients who had NLBBB. In this prospective observational study, they analyzed 24-hour telemetry in individuals who developed NLBBB during TAVI. The recording of baseline parameters and procedural and post-procedural data. The major outcome was the TTVP’s pace. Investigators assessed inappropriate TTVP use, electrophysiological study findings, permanent pacemaker (PPM) implantation, and remission of NLBBB. During TAVI, NLBBB developed in 83 patients (mean age of 74.4±8.7 years, 41.0% female). During the index hospitalization, 1 patient (1%) required TTVP due to total cardiac block and was administered a PPM. About 5 of the 83 patients (6%) were inadequately pace-controlled, and 1 patient (1%) developed ventricular fibrillation, possibly due to TTVP. Around 34 patients (41%) received an electrophysiological study while hospitalized, with 4 of 83 (5%) obtaining a PPM. Due to the COVID-19 pandemic, 1 patient (1%) died during hospitalization, and 9 patients were lost to follow-up. NLBBB resolved in 36 (49%) of the remaining 73 patients with a 30-day follow-up, whereas 2 (3%) were readmitted with total heart block and got PPM. In conclusion, temporary pacing was rarely required in patients with TAVI who develop NLBBB, which might pose extra hazards to the patient, and prolongs hospitalization duration.
Source – ajconline.org/article/S0002-9149(22)00422-2/fulltext
