PMID: 33221732Nov 23, 2020Paper

Impact of Rapid Ventricular Pacing During Transcatheter Implantation of Self-Expanding Aortic Valve Prostheses in Patients at Highest Risk.

The Journal of Invasive Cardiology
Ulrich Fischer-RasokatWon-Keun Kim

Abstract

Patients with low-flow, low-gradient (LFLG) aortic stenosis (AS) have the highest risk among all AS patients. Rapid ventricular pacing (RVP) is frequently used during transcatheter aortic valve implantation (TAVI), but may negatively impact critical left ventricular function in these patients. We investigated the effects of RVP in patients with LFLG-AS undergoing implantation of a self-expandable valve prosthesis. In this retrospective study, patients with LFLG-AS were classified according to the number of cumulative RVP episodes. Thirty-one patients with no episodes of RVP, 46 patients with 1 episode, and 40 patients with 2 or more episodes (2+) were identified. Society of Thoracic Surgeons (STS) scores in patients with 0, 1, or 2+ RVP episodes were 5.1% (interquartile range [IQR], 3.5%-8.9%), 6.0% (IQR, 3.8%-8.8%), and 4.8% (3.8%-8.1%), respectively. Peri-interventional adverse events tended to be highest in the group with 1 RVP. Residual aortic regurgitation was in 3.2%, 4.8%, and 2.6% (P=.87) in patients with 0, 1, and 2+ RVP episodes, respectively. Thirty-day mortality rates were 3.2%, 6.5%, and 7.5% (P=.74) and 1-year mortality rates were 22.6%, 30.4%, and 20.0% (P=.51) in patients with 0, 1, and 2+ RVP episodes, respecti...Continue Reading

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