Electrocardiogram during perioperative period of transcatheter aortic valve replacement: Characteristics and clinical implications / 第二军医大学学报

ABSTRACT

Objective: To summarize the characteristics and clinical implications of electrocardiogram (ECG) during the perioperative period of transcatheter aortic valve replacement (TAVR). Methods: From Dec. 2017 to Dec. 2018, 20 patients with severe aortic valve stenosis or severe aortic valve insufficiency who underwent TAVR were admitted to Department of Cardiovascular Surgery of our hospital. Eight cases had transapical aortic valve implantation with J-Valve self-expandable valves and 12 cases had transfemoral aortic valve implantation with Venus-A self-expandable valves. Arrhythmia incidence was analyzed based on the ECG results during perioperative period. Results: All the 20 cases were complicated with severe heart failure (New York Heart Association classification of cardiac function III-IV). The mean age of patients was (77.8 ± 4.9) years. TAVR was successfully performed in all the 20 patients. The mean follow-up period was (8.0 ± 3.1) months. In the Venus-A self-expandable valve group, there were 2 cases of new onset grade III atrioventricular block (resolved 7-12 d postoperatively), 6 cases of new onset left bundle branch block (LBBB), and 2 cases of new onset right bundle branch block (RBBB). In J-Valve self-expandable valve group, there were 4 cases of new onset LBBB, 2 cases of new onset RBBB and 3 cases of multifocal ventrical tachycardia plus ventricular premature beat. Conclusion: New onset LBBB arrhythmia has a high incidence during the perioperative period of TAVR.