Cardiac conduction disturbances common after placement of new-generation aortic valves

The implantation of self-expanding aortic values appears to trigger strong spikes in PR and QRS intervals, leading to high rates of high-degree cardiac conduction disturbances (HDCD) after hospital discharge, a recent study has found.

Researchers conducted a retrospective analysis of 344 consecutive patients (median age 83 years, 39.2 percent men) who had undergone transcatheter aortic valve replacement with a self-expanding valve for symptomatic aortic stenosis.

During hospitalization, PR interval in the overall cohort increased from a mean of 167.9 ms at baseline to 188.3 ms after the procedure. The difference value of 21.3 ms was statistically significant (p<0.001).

Meanwhile, PR dropped by a significant 7 ms at discharge. Nevertheless, the net change of 10.8 ms represented a statistically significant increase rom baseline (p<0.001), with 36.8 percent of patients seeing a final PR interval increase of ≥20 ms.

A similar effect was reported for QRS complex, which increased from a mean of 101.8 ms at baseline to 129.5 ms after placement (p<0.001). There was likewise a partial and significant resolution at discharge (p<0.001), but the net increase remained statistically significant (mean change, 21.4 ms; p<0.001).

In turn, placement of the new-generation self-expanding valves led to a 53.5-percent global incidence rate right after placement. Such changes resolved in 40 patients during hospitalization, leading to a final HDCD rate of 46.3 percent at discharge.

“These results should be validated in a largescale prospective study to corroborate their predictive capacity,” the researchers said.