Left bundle branch area versus conventional pacing after transcatheter valve implant for aortic stenosis: the LATVIA study.
J Cardiovasc Med (Hagerstown)
; 25(6): 450-456, 2024 Jun 01.
Article
em En
| MEDLINE
| ID: mdl-38625833
ABSTRACT
BACKGROUND:
Atrioventricular block (AVB) is a frequent complication in patients undergoing transcatheter aortic valve implantation (TAVI). Right apex ventricular pacing (RVP) represents the standard treatment but may induce cardiomyopathy over the long term. Left bundle branch area pacing (LBBAP) is a promising alternative, minimizing the risk of desynchrony. However, available evidence with LBBAP after TAVI is still low.OBJECTIVE:
To assess the feasibility and safety of LBBAP for AVB post-TAVI compared with RVP.METHODS:
Consecutive patients developing AVB early after TAVI were enrolled between 1 January 2022 and 31 December 2022 at three high-volume hospitals and received LBBAP or RVP. Data on procedure and at short-term follow-up (at least 3âmonths) were collected.RESULTS:
A total of 38 patients (61% men, mean age 83â±â6âyears) were included; 20 patients (53%) received LBBAP. Procedural success was obtained in all patients according to chosen pacing strategy. Electrical pacing performance at implant and after a mean follow-up of 4.2â±â2.8âmonths was clinically equivalent for both pacing modalities. In the LBBAP group, procedural time was longer (70â±â17 versus 58â±â15âmin in the RVP group, P â=â0.02) and paced QRS was shorter (120â±â19 versus 155â±â12âms at implant, P â<â0.001; 119â±â18 versus 157â±â9âms at follow-up, P â<â0.001). Complication rates did not differ between the two groups.CONCLUSION:
In patients with AVB after TAVI, LBBAP is feasible and safe, resulting in a narrow QRS duration, either acutely and during the follow-up, compared with RVP. Further studies are needed to evaluate if LBBAP reduces pacing-induced cardiomyopathy in this clinical setting.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Fascículo Atrioventricular
/
Estimulação Cardíaca Artificial
/
Estudos de Viabilidade
/
Bloqueio Atrioventricular
/
Substituição da Valva Aórtica Transcateter
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article