Electrophysiology Testing to Stratify Patients With Left Bundle Branch Block After Transcatheter Aortic Valve Implantation
Electrophysiology Testing to Stratify Patients With Left Bundle Branch Block After Transcatheter Aortic Valve Implantation
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DOI：
10.1161/jaha.119.014446
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发表时间：
2020-03-03
影响因子：
5.4
通讯作者：
Kuhne, Michael
中科院分区：
文献类型：
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作者：
Knecht, Sven;Schaer, Beat;Kuhne, Michael
背景左束支传导阻滞（LBBB）在经导管主动脉瓣植入术（TAVI）后很常见，是后续高级别房室传导阻滞（HAVB）的一个指标。目前尚无标准的方案来确定LBBB患者是否存在HAVB的风险。本研究的目的是评估TAVI后LBBB患者电生理研究量身定制策略的安全性和有效性。方法与结果对TAVI术后连续发生的LBBB患者进行前瞻性分析。电生理学研究测量TAVI后第二天的hv间期。心室（HV）间期正常的患者- 55 ms （pm组）。主要终点为随访12个月期间HAVB的发生情况。次要终点为症状、住院、装置植入或电生理研究引起的不良事件和死亡。在TAVI后筛查的373例患者中，包括56例LBBB患者（826岁，41%为男性）。il - r组41例患者中有4例（10%）发生HAVB， pm组15例患者中有8例（53%）发生HAVB
Background Left bundle branch block (LBBB) is common after transcatheter aortic valve implantation (TAVI) and is an indicator of subsequent high-grade atrioventricular block (HAVB). No standardized protocol is available to identify LBBB patients at risk for HAVB. The aim of the current study was to evaluate the safety and efficacy of an electrophysiology study tailored strategy in patients with LBBB after TAVI.Methods and Results We prospectively analyzed consecutive patients with LBBB after TAVI. An electrophysiology study was performed to measure the HV-interval the day following TAVI. In patients with normal His-ventricular (HV)-interval 55 ms (PM-group). The primary end point was occurrence of HAVB during a follow-up of 12 months. Secondary end points were symptoms, hospitalizations, adverse events because of device implantation or electrophysiology study, and death. Of 373 patients screened after TAVI, 56 patients (826 years, 41% male) with LBBB were included. HAVB occurred in 4 of 41 patients (10%) in the ILR-group and in 8 of 15 patients (53%) in the PM-group (P