p.47 抽出テキスト

Table 10 Predictors for permanent pacing after transcatheter aortic valve implantation

Characteristics References ECG

Right BBB 512528 PR-interval prolongation 517,521,525,527 Left anterior hemiblock 517,525 Patient

Older age (per 1-year increase) 529 Male sex 518,519,525,529 Larger body mass index (per 1-unit increase) 529 Anatomical

Severe mitral annular calcification 512,515 LV outflow tract calcifications 522 Membranous septum length 528,530 Porcelain aorta 531 Higher mean aortic valve gradient 519 Procedural

Self-expandable valve 512,513,525,529,531 Deeper valve implantation 517,518,520,522,528,532 Larger ratio between prosthesis diameter versus annulus or LV outflow tract diameter 524,529,532 Balloon post-dilatation 519,521,529 TAVI in native valve vs. valve-in-valve procedure 531 AVB = atrioventricular block; BBB = bundle branch block; ECG = electrocardiogram; LV = left ventricular; TAVI = transcatheter aortic valve implantation. For more detailed data, see Supplementary Tables 14 and 15.

Management of conduction abnormalities in patients afterTAVI

Persistenta high degree AVB New onset alternating BBB Pre-existing RBBB

with new post-procedure

conduction disturbanceb Persistent new

LBBB with QRS > 150 ms or PR > 240 ms with no further prolongation during > 48h after procedurec Pre-existing

conduction abnormality with prolongation of QRS (> 20 ms) or

PR (> 20 ms)f

Ambulatory ECG

monitoringd (Class IIa) Ambulatory ECG

monitoringd (Class IIb)

OR OR

EPSe

(Class IIa) EPSe

(Class IIb)

Permanent PM

(Class I) Permanent PM

(Class IIa)

Figure 12 Management of conduction abnormalities after transcatheter aortic valve implantation. AF = atrial fibrillation; AV = atrioventricular; AVB = atrioventricular block; BBB = bundle branch block; ECG = electrocardiogram; EPS = electrophysiology study; HV = Hisventricular interval; LBBB = left bundle branch block; LVEF = left ventricular ejection fraction; PM = pacemaker; QRS = Q, R, and S waves; RBBB = right bundle branch block; TAVI = transcatheter aortic valve implantation. a24-48 h post-procedure. bTransient high-degree AVB, PR prolongation, or axis change. cHigh-risk parameters for high-degree AV block in patients with new-onset LBBB include: AF, prolonged PR interval, and LVEF <40%. dAmbulatory continuous ECG monitoring for 7 - 30 days. eEPS with HV >_70 ms may be considered positive for permanent pacing. fWith no further prolongation of QRS or PR during 48-h observation. ESC 2021 Downloaded from academic.oup.com/eurheartj/article/42/35/3427/6358547 by guest on 07 October 2026