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Consecutive patients with high grade aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) with a self-expanding valve (Medtronic CoreValve Evolut R® or Edwards Sapien S3®) without pre-existing pacemaker devices are eligible for inclusion. During the TAVR procedure, an electrophysiologic study including measurements of infranodal conduction times (HV-interval before and after valve implantation) will be performed. Electrocardiograms before TAVR, before discharge, after 30 days and after 12 months will be analyzed regarding new onset LBB and the occurrence of high-degree AV block (HAVB) .
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EPS arm | Other | Limited electrophysiologic study including measurements of HV- and AH-intervals pre- and post-TAVR |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Limited electrophysiologic study including measurements of HV- and AH-intervals pre- and post-TAVR | Diagnostic Test | For the purpose of obtaining intracardiac measurements, the quadripolar diagnostic catheter used as temporary pacemaker wire (5F, Woven, Boston Scientific) during TAVR was retracted from the apex and positioned at the His bundle to measure HV- and AH-intervals. |
| Measure | Description | Time Frame |
|---|---|---|
| High-degree AV block | Occurence of high-degree AV block necessitating a pacemaker implantation during follow up | 24 months |
| Persistence of left bundle-branch block | Persistence of new onset left bundle branch-block following TAVR procedure | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Differences between implanted valve types on ifranodal conduction | 24 months |
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Inclusion Criteria:
Exclusion Criteria:
1. Pre-existent intracardiac device as pacemaker, implanted cardioverter defibrillator or CRT-P/CRT-D device
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christian Ukena, MD | Contact | 004968411615912 | christian.ukena@uks.eu | |
| Valerie Pavlicek, MD | Contact | 004968411615912 | valerie.pavlicek@uks.eu |
| Name | Affiliation | Role |
|---|---|---|
| Christian Ukena, MD | Universitätsklinikum des Saarlandes, Homburg/Saar, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitätsklinikum des Saarlandes | Recruiting | Homburg | Saarland | 66421 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28963581 | Background | Gaede L, Kim WK, Liebetrau C, Dorr O, Sperzel J, Blumenstein J, Berkowitsch A, Walther T, Hamm C, Elsasser A, Nef H, Mollmann H. Pacemaker implantation after TAVI: predictors of AV block persistence. Clin Res Cardiol. 2018 Jan;107(1):60-69. doi: 10.1007/s00392-017-1158-2. Epub 2017 Sep 29. | |
| 24179072 | Background |
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| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| D002037 | Bundle-Branch Block |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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|
| Nazif TM, Williams MR, Hahn RT, Kapadia S, Babaliaros V, Rodes-Cabau J, Szeto WY, Jilaihawi H, Fearon WF, Dvir D, Dewey TM, Makkar RR, Xu K, Dizon JM, Smith CR, Leon MB, Kodali SK. Clinical implications of new-onset left bundle branch block after transcatheter aortic valve replacement: analysis of the PARTNER experience. Eur Heart J. 2014 Jun 21;35(24):1599-607. doi: 10.1093/eurheartj/eht376. Epub 2013 Oct 30. |
| 23040577 | Background | Urena M, Mok M, Serra V, Dumont E, Nombela-Franco L, DeLarochelliere R, Doyle D, Igual A, Larose E, Amat-Santos I, Cote M, Cuellar H, Pibarot P, de Jaegere P, Philippon F, Garcia del Blanco B, Rodes-Cabau J. Predictive factors and long-term clinical consequences of persistent left bundle branch block following transcatheter aortic valve implantation with a balloon-expandable valve. J Am Coll Cardiol. 2012 Oct 30;60(18):1743-52. doi: 10.1016/j.jacc.2012.07.035. Epub 2012 Oct 3. |
| 36680617 | Derived | Pavlicek V, Mahfoud F, Bubel K, Fries P, Ewen S, Bohm M, Scheller B, Ukena C. Prediction of conduction disturbances in patients undergoing transcatheter aortic valve replacement. Clin Res Cardiol. 2023 May;112(5):677-690. doi: 10.1007/s00392-023-02160-0. Epub 2023 Jan 21. |
| D014694 |
| Ventricular Outflow Obstruction |
| D006327 | Heart Block |
| D001145 | Arrhythmias, Cardiac |
| D000075224 | Cardiac Conduction System Disease |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |