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Chang S, Liu X, Lu ZN, Yao J, Yin C, Wu W, Yuan F, Luo T, Liu R, Yan Y, Zhang Q, Pu J, Modine T, Piazza N, Jilaihawi H, Jiang Z, Song G. Feasibility study of temporary permanent pacemaker in patients with conduction block after TAVR. Front Cardiovasc Med 2023; 10:978394. [PMID: 36760563 PMCID: PMC9905124 DOI: 10.3389/fcvm.2023.978394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Background Limited data exist on the use of temporary permanent pacemaker (TPPM) to reduce unnecessary PPM in patients with high-degree atrioventricular block (HAVB) after transcatheter aortic valve replacement (TAVR). Objectives This study aims to determine the feasibility of TPPM in patients with HAVB after TAVR to provide prolonged pacing as a bridge. Materials and methods One hundred and eleven consecutive patients undergoing TAVR were screened from August 2021 to June 2022. Patients with HAVB eligible for PPM were included. TPPM were used in these patients instead of conventional temporary pacing or early PPM. Patients were followed up for 1 month. Holter and pacemaker interrogation were used to determine whether to implant PPM. Results Twenty one patients met the inclusion criteria for TPPM, of which 14 patients were third-degree AVB, 1 patient was second-degree AVB, 6 patients were first degree AVB with PR interval > 240 ms and LBBB with QRS duration > 150 ms. TPPM were placed on the 21 patients for 35 ± 7 days. Among 15 patients with HAVB, 26.7% of them (n = 4) recovered to sinus rhythm; 46.7% (n = 7) recovered to sinus rhythm with bundle branch block. The remains of 26.7% patients (n = 4) still had third-degree AVB and received PPM. For patients with first-degree AVB and LBBB, PR interval shortened to < 200 ms in all 6 patients and LBBB recovered in 2 patients. TPPM were successfully removed from all patients and no procedure-related adverse events occurred. Conclusion TPPM is reliable and safe in the small sample of patients with conduction block after TAVR to provide certain buffer time to distinguish whether a PPM is necessary. Future studies with larger sample are needed for further validation of the current results.
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Affiliation(s)
- Sanshuai Chang
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Xinmin Liu
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Zhi-Nan Lu
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Jing Yao
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Chengqian Yin
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Wenhui Wu
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Fei Yuan
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Taiyang Luo
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Ran Liu
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Yunfeng Yan
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Qian Zhang
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Junzhou Pu
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China
| | - Thomas Modine
- UMCV, Hôpital Haut Leveque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Nicolo Piazza
- Montreal and German Heart Centre, McGill University Health Center, Munich, Germany
| | | | - Zhengming Jiang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Zhengming Jiang,
| | - Guangyuan Song
- Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, National Clinical Research Centre for Cardiovascular Diseases, Capital Medical University, Beijing, China,Guangyuan Song,
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Gill KP, Gulhar R, Hayase J, Koppula AS. Fibrosing Mediastinitis Causing High Degree AV Block in a Young Female Patient. JACC Case Rep 2022; 7:101717. [PMID: 36776794 PMCID: PMC9911910 DOI: 10.1016/j.jaccas.2022.101717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 12/30/2022]
Abstract
A 30-year-old woman presented with presyncopal episodes and was found to have high degree atrioventricular block. Computed tomography imaging demonstrated pericardial thickening extending from the main pulmonary artery to the aortic cusps. Here we present a rare case of fibrosing mediastinitis causing high-degree atrioventricular block. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Karam P.S. Gill
- Address for correspondence: Dr Karam P.S. Gill, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, California 91342, USA. @KGill618
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