Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address: https://twitter.com/MuntaneCarol.
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
J Am Coll Cardiol. 2021 Mar 16;77(10):1344-1356. doi: 10.1016/j.jacc.2020.12.062.
Transcatheter aortic valve replacement (TAVR) has changed the treatment of patients with severe aortic stenosis. However, the occurrence of conduction disturbances has not decreased significantly over time and remains the main drawback of the procedure. In addition, new-onset atrial fibrillation is the most frequent tachyarrhythmia during the hospitalization period and is associated with worse clinical outcomes. However, little is known regarding the incidence and clinical impact of arrhythmic events beyond the periprocedural TAVR period. Ambulatory electrocardiogram (AECG) monitoring has recently emerged as a tool to unravel the complex issue of arrhythmic disorders (bradyarrhythmias and tachyarrhythmias) before and after TAVR. To date, the preliminary results from the initial experience using AECG monitoring systems showed the safety, usefulness, and potential clinical implications of this diagnostic tool in TAVR recipients. This review provides an overview of the current status, clinical implications, and future perspectives of AECG monitoring in the TAVR setting.
经导管主动脉瓣置换术（TAVR）改变了严重主动脉瓣狭窄患者的治疗方法。然而，随着时间的推移，传导障碍的发生率并没有显著降低，仍然是该手术的主要缺点。此外，新发心房颤动是住院期间最常见的快速性心律失常，与更差的临床结局相关。然而，对于 TAVR 围手术期以外的心律失常事件的发生率和临床影响知之甚少。动态心电图（AECG）监测最近已成为一种工具，可在 TAVR 前后揭示心律失常（缓慢性和快速性心律失常）的复杂问题。迄今为止，使用 AECG 监测系统的初步经验结果表明，该诊断工具在 TAVR 受者中的安全性、有用性和潜在临床意义。这篇综述提供了 TAVR 环境中 AECG 监测的现状、临床意义和未来展望的概述。
