Lin Shu-I, Miura Mizuki, Tagliari Ana Paula, Lee Ying-Hsian, Shirai Shinichi, Puri Rishi, Maisano Francesco, Taramasso Maurizio
Cardiovascular Center, MacKay Memorial Hospital Taipei, Taiwan.
Department of Cardiac Surgery, University Hospital Zurich Zurich, Switzerland.
Interv Cardiol. 2020 Jul 29;15:e11. doi: 10.15420/icr.2020.07. eCollection 2020 Apr.
Despite significant improvements in transcatheter aortic valve implantation (TAVI) outcomes, periprocedural conduction disturbances, such as new-onset left bundle branch block (LBBB) and new pacemaker implantation (PMI), remain relatively frequent concerns. The development of periprocedural conduction disturbances can be explained by the proximity between the aortic valve and the conduction system. Although prior studies reported heterogeneity in PMI rates after TAVI, current evidence supports the potentially deleterious consequence of LBBB and PMI, and several predisposing factors have been reported. Therefore, new strategies to avoid conduction disturbances and to improve their management are required, particularly with the current trend to expand TAVI to a low-risk population.
尽管经导管主动脉瓣植入术(TAVI)的疗效有了显著改善,但围手术期传导障碍,如新发性左束支传导阻滞(LBBB)和新的起搏器植入(PMI),仍然是相对常见的问题。围手术期传导障碍的发生可归因于主动脉瓣与传导系统的接近程度。虽然先前的研究报道了TAVI术后PMI发生率的异质性,但目前的证据支持LBBB和PMI可能产生的有害后果,并且已经报道了一些易感因素。因此,需要新的策略来避免传导障碍并改善其管理,特别是在当前将TAVI扩展到低风险人群的趋势下。