Authors
- Ivana Hodanić — Klinički bolnički centar Rijeka, Rijeka, Hrvatska — ORCID: 0000-0002-3403-4773
- Marina Klasan — Klinički bolnički centar Rijeka, Rijeka, Hrvatska — ORCID: 0000-0001-9863-4113
- Saša Bura — Klinički bolnički centar Rijeka, Rijeka, Hrvatska — ORCID: 0000-0001-5937-4865
- Katarina Matković — Klinički bolnički centar Rijeka, Rijeka, Hrvatska — ORCID: 0000-0002-6868-3579
- Boris Barac — Klinički bolnički centar Rijeka, Rijeka, Hrvatska — ORCID: 0000-0001-8118-1867
Keywords
transcatheter aortic valve implantation, elektrostimulation
DOI
https://doi.org/10.15836/ccar2021.350Full Text
The most common valve disease is aortic stenosis, its prevalence increases with increasing age of the population. The prevalence averages 2 to 4% in patients over 65 years of age. ( 1 ) Almost a third of patients do not have cardiac surgery for aortic stenosis due to high operative risk and comorbidity. Therefore, transcatheter aortic valve implantation (TAVI) is being performed more and more often. With this method, an artificial biological valve is inserted into the place of the degenerated native valve on the “beating” heart, with the help of a catheter. If the patient has not previously been implanted with a permanent pacemaker, a temporary pacemaker should be installed. Electrostimulation of the heart during aortic valve placement serves to briefly induce ventricular tachycardia during balloon dilatation and release of the valve from the catheter. Due to the anatomical correlation between the structure of the aortic valve and the conduction system of the heart, one of the most common complications after TAVI are disorders of the conduction system involving branch bundle block, complete heart block, and the need for permanent pacemaker implantation. Although these disorders are not usually fatal, they can have a major impact on patients ’condition and long-term consequences. There are several risk factors for conduction disturbances, including age, heart anatomy, periprocedural factors, type of valve implanted, pre-existing abnormalities, and comorbidities. As this technique becomes increasingly familiar to physicians, patients need to be prepared in order to minimize the development of cardiac conduction disorders after TAVI.