Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation

Stefan Toggweiler*, Henrik Nissen, Brynjolfur Mogensen, Florim Cuculi, Christian Fallesen, Karsten Tange Veien, Miriam Brinkert, Richard Kobza, Andreas Rück

*Kontaktforfatter for dette arbejde

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Resumé

Aims: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. Methods and results: A total of 175 patients (58% female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3%) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3%) developed a new left bundle branch block, 13 (7%) a new first-degree AV block, and four (2.3%) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7%), mild in 101 (57.7%) and moderate in eight (4.6%). At 30 days, the rate of any stroke was 1.7% (3/175), and one patient (0.6%) had died. Conclusions: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.

OriginalsprogEngelsk
TidsskriftEuroIntervention
Vol/bind13
Udgave nummer11
Sider (fra-til)1274-1281
ISSN1774-024X
DOI
StatusUdgivet - 2017

Fingeraftryk

Heart Valves
Prostheses and Implants
Atrioventricular Block
Dilatation
Wounds and Injuries

Citer dette

Toggweiler, Stefan ; Nissen, Henrik ; Mogensen, Brynjolfur ; Cuculi, Florim ; Fallesen, Christian ; Tange Veien, Karsten ; Brinkert, Miriam ; Kobza, Richard ; Rück, Andreas. / Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation. I: EuroIntervention. 2017 ; Bind 13, Nr. 11. s. 1274-1281.
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title = "Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation",
abstract = "Aims: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. Methods and results: A total of 175 patients (58{\%} female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3{\%}) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3{\%}) developed a new left bundle branch block, 13 (7{\%}) a new first-degree AV block, and four (2.3{\%}) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7{\%}), mild in 101 (57.7{\%}) and moderate in eight (4.6{\%}). At 30 days, the rate of any stroke was 1.7{\%} (3/175), and one patient (0.6{\%}) had died. Conclusions: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.",
keywords = "Aortic stenosis, Atrioventricular block, Balloon valvuloplasty, Transcatheter aortic valve implantation (TAVI)",
author = "Stefan Toggweiler and Henrik Nissen and Brynjolfur Mogensen and Florim Cuculi and Christian Fallesen and {Tange Veien}, Karsten and Miriam Brinkert and Richard Kobza and Andreas R{\"u}ck",
year = "2017",
doi = "10.4244/EIJ-D-17-00252",
language = "English",
volume = "13",
pages = "1274--1281",
journal = "EuroIntervention",
issn = "1774-024X",
publisher = "Europa Digital & Publishing",
number = "11",

}

Toggweiler, S, Nissen, H, Mogensen, B, Cuculi, F, Fallesen, C, Tange Veien, K, Brinkert, M, Kobza, R & Rück, A 2017, 'Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation', EuroIntervention, bind 13, nr. 11, s. 1274-1281. https://doi.org/10.4244/EIJ-D-17-00252

Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation. / Toggweiler, Stefan; Nissen, Henrik; Mogensen, Brynjolfur; Cuculi, Florim; Fallesen, Christian; Tange Veien, Karsten; Brinkert, Miriam; Kobza, Richard; Rück, Andreas.

I: EuroIntervention, Bind 13, Nr. 11, 2017, s. 1274-1281.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Very low pacemaker rate following ACURATE neo transcatheter heart valve implantation

AU - Toggweiler, Stefan

AU - Nissen, Henrik

AU - Mogensen, Brynjolfur

AU - Cuculi, Florim

AU - Fallesen, Christian

AU - Tange Veien, Karsten

AU - Brinkert, Miriam

AU - Kobza, Richard

AU - Rück, Andreas

PY - 2017

Y1 - 2017

N2 - Aims: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. Methods and results: A total of 175 patients (58% female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3%) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3%) developed a new left bundle branch block, 13 (7%) a new first-degree AV block, and four (2.3%) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7%), mild in 101 (57.7%) and moderate in eight (4.6%). At 30 days, the rate of any stroke was 1.7% (3/175), and one patient (0.6%) had died. Conclusions: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.

AB - Aims: The aim of this study was to investigate whether minimising trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and the need for permanent pacemakers. Methods and results: A total of 175 patients (58% female, mean age 83±6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centres in Europe. Prosthesis size selection was based on perimeter-derived annular diameter. Predilatation was performed in all with a balloon 1.9±0.9 mm smaller than the perimeter-derived annular diameter. Post-dilatation was performed in 46 (26.3%) with a balloon 1.2±0.9 mm smaller than the perimeter-derived annular diameter. Eighteen patients (10.3%) developed a new left bundle branch block, 13 (7%) a new first-degree AV block, and four (2.3%) received a new permanent pacemaker. Paravalvular regurgitation was none/trace in 66 (37.7%), mild in 101 (57.7%) and moderate in eight (4.6%). At 30 days, the rate of any stroke was 1.7% (3/175), and one patient (0.6%) had died. Conclusions: With careful selection of the balloon and the ACURATE neo prosthesis size, very low rates of new conduction disorders and permanent pacemaker implantation may be achieved without increasing the amount of paravalvular regurgitation.

KW - Aortic stenosis

KW - Atrioventricular block

KW - Balloon valvuloplasty

KW - Transcatheter aortic valve implantation (TAVI)

U2 - 10.4244/EIJ-D-17-00252

DO - 10.4244/EIJ-D-17-00252

M3 - Journal article

VL - 13

SP - 1274

EP - 1281

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 11

ER -