1
|
Defaye P, Biffi M, El-Chami M, Boveda S, Glikson M, Piccini J, Vitolo M. Cardiac pacing and lead devices management: 25 years of research at EP Europace journal. Europace 2023; 25:euad202. [PMID: 37421338 PMCID: PMC10450798 DOI: 10.1093/europace/euad202] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023] Open
Abstract
AIMS Cardiac pacing represents a key element in the field of electrophysiology and the treatment of conduction diseases. Since the first issue published in 1999, EP Europace has significantly contributed to the development and dissemination of the research in this area. METHODS In the last 25 years, there has been a continuous improvement of technologies and a great expansion of clinical indications making the field of cardiac pacing a fertile ground for research still today. Pacemaker technology has rapidly evolved, from the first external devices with limited longevity, passing through conventional transvenous pacemakers to leadless devices. Constant innovations in pacemaker size, longevity, pacing mode, algorithms, and remote monitoring highlight that the fascinating and exciting journey of cardiac pacing is not over yet. CONCLUSION The aim of the present review is to provide the current 'state of the art' on cardiac pacing highlighting the most important contributions from the Journal in the field.
Collapse
Affiliation(s)
- Pascal Defaye
- Cardiology Department, University Hospital and Grenoble Alpes University, CS 10217, Grenoble Cedex 9, Grenoble 38043, France
| | - Mauro Biffi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Mikhael El-Chami
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Serge Boveda
- Clinique Pasteur, Heart Rhythm Department, Toulouse, France
| | - Michael Glikson
- Cardiology Department, Jesselson Integrated Heart Center Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Jonathan Piccini
- Duke University, Duke Clinical Research Institute, Durham, NC, USA
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico Di Modena, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
2
|
Tagliari AP, Taramasso M. New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023. J Clin Med 2023; 12:jcm12041342. [PMID: 36835878 PMCID: PMC9964275 DOI: 10.3390/jcm12041342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious sedation, and the avoidance of invasive lines becoming the new standards. Here, we discuss the minimalist TAVI approach and how we incorporate it into our current clinical practice.
Collapse
Affiliation(s)
- Ana Paula Tagliari
- Cardiovascular Surgery Department, Hospital São Lucas da PUC-RS, Porto Alegre 90619-900, Brazil
- Cardiovascular Surgery Department, Hospital Mãe de Deus, Porto Alegre 90880-0481, Brazil
- Correspondence: ; Tel.: +55-(51)-33205186
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Clinic of Cardiac Surgery, 8008 Zurich, Switzerland
| |
Collapse
|
3
|
Saadi M, Tagliari AP, Danzmann LC, Bartholomay E, Kochi AN, Saadi EK. Update in Heart Rhythm Abnormalities and Indications for Pacemaker After Transcatheter Aortic Valve Implantation. Braz J Cardiovasc Surg 2019; 33:286-290. [PMID: 30043922 PMCID: PMC6089127 DOI: 10.21470/1678-9741-2017-0206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022] Open
Abstract
Objective: Rhythm abnormalities following transcatheter aortic valve implantation
(TAVI) and indications for permanent pacemaker implantation (PPI) were reviewed,
which aren't well established in the current guidelines. New left bundle branch
block and atrioventricular block are the most common electrocardiographic
changes after TAVI. PPI incidence ranges from 9-42% for self-expandable and
2.5-11.5% for balloon expandable devices. Not only anatomical variations in
conduction system have an important role in conduction disorders, but different
valve characteristics and their relationship with cardiac structures as well.
Previous right bundle branch block has been confirmed as one of the most
significant predictors for PPI.
Collapse
Affiliation(s)
- Marina Saadi
- Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Ana Paula Tagliari
- Department of Cardiovascular Surgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Luiz Cláudio Danzmann
- Department of Cardiology, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Eduardo Bartholomay
- Department of Cardiology, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Adriano Nunes Kochi
- Department of Cardiology, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Eduardo Keller Saadi
- Department of Cardiovascular Surgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
4
|
Barbanti M, Gulino S, Costa G, Tamburino C. Optimization and simplification of transcatheter aortic valve implantation therapy. Expert Rev Cardiovasc Ther 2018; 16:287-296. [PMID: 29508624 DOI: 10.1080/14779072.2018.1449644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Transcatheter aortic valve implantation (TAVI) is now a widely adopted therapy for the treatment of elderly patients with severe aortic stenosis. Improved pre-procedural screening, increased operators' experience and technology advancement have made this technique highly reliable and standardized. Areas covered: The purpose of this review article is to provide an overview of the strategies that can be adopted to optimize the TAVI procedure (pre-interventional work-up and procedural simplification and early discharge). Expert commentary: Optimization of TAVI therapy is already a reality and has shown to be safe in most patients, but its penetration has to face with real-world practice. The adoption of a minimalistic and optimized approach requires integration of multidisciplinary competences and an extended, dynamic conception of heart team, which also includes patients' families, referring cardiologist and general practitioners.
Collapse
Affiliation(s)
- Marco Barbanti
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Simona Gulino
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Giuliano Costa
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Corrado Tamburino
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| |
Collapse
|
5
|
Alasti M, Rashid H, Rangasamy K, Kotschet E, Adam D, Alison J, Gooley R, Zaman S. Long-term pacemaker dependency and impact of pacing on mortality following transcatheter aortic valve replacement with the LOTUS valve. Catheter Cardiovasc Interv 2018; 92:777-782. [DOI: 10.1002/ccd.27463] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/01/2017] [Accepted: 11/25/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Mohammad Alasti
- Monash Cardiac Rhythm Management Department; MonashHeart, Monash Medical Centre; Melbourne Australia
| | - Hashrul Rashid
- Monash Cardiovascular Research Centre, MonashHeart, Monash Medical Centre and Monash University; Melbourne Australia
| | - Karthikeyan Rangasamy
- Monash Cardiac Rhythm Management Department; MonashHeart, Monash Medical Centre; Melbourne Australia
| | - Emily Kotschet
- Monash Cardiac Rhythm Management Department; MonashHeart, Monash Medical Centre; Melbourne Australia
| | - David Adam
- Monash Cardiac Rhythm Management Department; MonashHeart, Monash Medical Centre; Melbourne Australia
| | - Jeff Alison
- Monash Cardiac Rhythm Management Department; MonashHeart, Monash Medical Centre; Melbourne Australia
| | - Robert Gooley
- Monash Cardiovascular Research Centre, MonashHeart, Monash Medical Centre and Monash University; Melbourne Australia
| | - Sarah Zaman
- Monash Cardiovascular Research Centre, MonashHeart, Monash Medical Centre and Monash University; Melbourne Australia
| |
Collapse
|
6
|
Barbanti M, Gulino S, Costa G, Tamburino C. Pathophysiology, incidence and predictors of conduction disturbances during Transcatheter Aortic Valve Implantation. Expert Rev Med Devices 2017; 14:135-147. [PMID: 28092726 DOI: 10.1080/17434440.2017.1282819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Over the past decade, transcatheter aortic valve implantation (TAVI) has evolved rapidly toward an extremely reproducible, safe and effective procedure, with a marked reduction of its related complications. However, the occurrence of conduction disturbances and the need for permanent pacemaker implantation (PPI) after TAVI remains a concern. Areas covered: In this article review, we will go through the mechanisms involved in conduction disturbances after TAVI, and we will discuss the key aspects of pathophysiology, incidence and predictors of conduction disturbances following Transcatheter Aortic Valve Implantation. The evaluation of patient's valve anatomy and the selection of the most appropriate prosthesis have been proposed as a valuable options to reduce the incidence of conductions disturbances. Moreover, in recent times, a great number of new TAVI devices, so-called 'second-generation devices', have been introduced to address the limitations of the first-generation devices, including conduction disturbance, with scarce results. Expert commentary: Conduction disturbances after TAVI are increasingly recognized as an important issue in TAVI complications. Further characterization of the procedural- and patient-related factors that contribute to the development of conduction abnormalities will help to improve prosthesis designs and patient selection, making TAVI even more safer.
Collapse
Affiliation(s)
- Marco Barbanti
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Simona Gulino
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Giuliano Costa
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| | - Corrado Tamburino
- a Division of Cardiology , Ferrarotto Hospital, University of Catania , Catania , Italy
| |
Collapse
|
7
|
Moini C, Sidia B, Poindron D, Fiorina L, Farge A, Amara W, El Issa M. [Cardiac permanent pacemaker after transcatheter aortic valve implantation: A predictive and scientific review]. Ann Cardiol Angeiol (Paris) 2016; 65:346-351. [PMID: 27693168 DOI: 10.1016/j.ancard.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i.e when that size is inferior to the valve's one) and the QRS duration after the procedure (the superior threshold has been set at 128ms for the Corevalve). The currently recommendations advice to implant a pacemaker are as followed: high grade AV block (in the main studies, the implantation occurs within the 5 days after the TAVI), complete and transient AV block during the TAVI, second degree AV block and RBBB associated with first degree AV block. Our article aims to review the arrhythmic issues of TAVI.
Collapse
Affiliation(s)
- C Moini
- Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France; Service de cardiologie, centre hospitalier de Melun, 2, rue Fréteau-de-Peny, 77011 Melun cedex, France
| | - B Sidia
- Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France
| | - D Poindron
- Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France
| | - L Fiorina
- Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France; Unité de rythmologie et de stimulation cardiaque, clinique Les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France
| | - A Farge
- Unité de chirurgie cardiaque, hôpital Jacques-Cartier, 6, avenue du Noyer-Lambert, 91300 Massy, France
| | - W Amara
- Unité de rythmologie, GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France
| | - M El Issa
- Unité de rythmologie et de stimulation cardiaque, hôpital d'Antony, 1, rue Velpeau, 92160 Antony, France.
| |
Collapse
|
8
|
Conduction disturbances after transcatheter aortic valve implantation procedures - predictors and management. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2016; 12:203-11. [PMID: 27625682 PMCID: PMC5011535 DOI: 10.5114/aic.2016.61640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/29/2016] [Indexed: 12/02/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients’ state and long term-survival. The most relevant and common are His’ bundle branch blocks, atrioventricular blocks, and need for permanent pacemaker implantation. With the frequency at 10% to even 50%, conduction abnormalities are among the most important TAVI-related adverse events. Risk factors for conduction disturbances include age, anatomy of the heart, periprocedural factors, type of implanted valve, and comorbidities. Severity of occurring complications varies; therefore selection of a proper treatment approach is required. Considered as the most effective management, permanent pacemaker implantation turned out to negatively influence both recovery and survival. Moreover, there is no expert consensus on use of resynchronization therapy after TAVI. In this paper, the authors present a comprehensive analysis of the most common conduction disturbances accompanying TAVI, factors related to their occurrence, and treatment approach.
Collapse
|
9
|
SIDERIS SKEVOS, BENETOS GEORGIOS, TOUTOUZAS KONSTANTINOS, DRAKOPOULOU MARIA, SOTIROPOULOS ELIAS, GATZOULIS KONSTANTINOS, LATSIOS GEORGE, SYNETOS ANDREAS, TRANTALIS GEORGE, TOUSOULIS DIMITRIS, KALLIKAZAROS IOANNIS. Outcomes of Same Day Pacemaker Implantation after TAVI. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:690-5. [DOI: 10.1111/pace.12871] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/13/2016] [Accepted: 04/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- SKEVOS SIDERIS
- Cardiac Department; Hippokration Hospital; Athens Greece
| | - GEORGIOS BENETOS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - KONSTANTINOS TOUTOUZAS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - MARIA DRAKOPOULOU
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | | | - KONSTANTINOS GATZOULIS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - GEORGE LATSIOS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - ANDREAS SYNETOS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - GEORGE TRANTALIS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | - DIMITRIS TOUSOULIS
- First Department of Cardiology, Hippokration Hospital; Athens School of Medicine; Athens Greece
| | | |
Collapse
|
10
|
Gandhi S, Schwalm JDR, Velianou JL, Natarajan MK, Farkouh ME. Comparison of Dual-antiplatelet Therapy to Mono-antiplatelet Therapy After Transcatheter Aortic Valve Implantation: Systematic Review and Meta-analysis. Can J Cardiol 2015; 31:775-84. [DOI: 10.1016/j.cjca.2015.01.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 01/15/2015] [Accepted: 01/19/2015] [Indexed: 11/24/2022] Open
|
11
|
Calvi V, Pruiti GP. Pacemaker implantation and need for ventricular pacing during follow-up after transcatheter aortic valve implantation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 37:1589-91. [PMID: 25319956 DOI: 10.1111/pace.12524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 08/21/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Valeria Calvi
- From the Arrhythmology Unit, Ferrarotto Hospital, University of Catania, Via Citelli, Italy
| | | |
Collapse
|
12
|
Clinical significance of conduction disturbances after aortic valve intervention: current evidence. Clin Res Cardiol 2014; 104:1-12. [DOI: 10.1007/s00392-014-0739-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 06/24/2014] [Indexed: 12/16/2022]
|
13
|
Morís C, Rubín JM. Conduction disorders and transcatheter aortic valve. Clinically relevant or just a mild complication? ACTA ACUST UNITED AC 2014; 66:692-4. [PMID: 24773673 DOI: 10.1016/j.rec.2013.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
Affiliation(s)
- César Morís
- Unidad de Hemodinámica y Cardiología Intervencionista, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
| | - José M Rubín
- Unidad de Electrofisiología y Marcapasos, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| |
Collapse
|
14
|
Trastornos de la conducción y válvula aórtica transcatéter. ¿Tienen relevancia clínica o son solo una leve complicación? Rev Esp Cardiol 2013. [DOI: 10.1016/j.recesp.2013.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|