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Background and aims <p>High-grade atrioventricular conduction disorders or blocks (HAVB) are common complications following Transcatheter Aortic Valve Implantation (TAVI). This study aimed to evaluate the incidence and prognostic significance of PR interval prolongation at Day 1 (D1) after TAVI on the risk of HAVB and pacemaker implantation (PPI).</p> Methods <p>This is a single-center retrospective cohort including 1151 patients who underwent TAVI from January 2010 to December 2020. PR interval prolongation was measured between pre-TAVI and D1 ECG. The primary endpoint was HAVB leading to PPI at 10&#xa0;days. Based on multivariable model, Day-1 ECG risk score was developed using PR, QRS duration and valve type.</p> Results <p>The mean PR interval prolongation at D1 was 8 ± 28&#xa0;ms, 20.8% developed a type 1 AV block. A PR-interval prolongation ≥ 40&#xa0;ms at Day 1 was an independent predictor of HAVB requiring PPI in patients with QRS ≥ 100&#xa0;ms (HR = 2.8 [1.8–4.1], <i>p</i> &lt; 0.001), with a 10-day incidence of 39.2%, compared with 7.0% in those with QRS &lt; 100&#xa0;ms (<i>p</i> &lt; 0.001). The Day-1 ECG risk score classified patients according to increasing 10-day HAVB rates of 5.4%, 17.7%, and 32.7% in the low-, intermediate-, and high-risk groups, respectively (<i>p</i> &lt; 0.001).</p> Conclusions <p>PR interval prolongation ≥ 40&#xa0;ms at D1 after Transcatheter Aortic Valve Implantation is a strong predictor of high-grade atrioventricular conduction disorders or blocks requiring pacemaker implantation, particularly in patients with QRS ≥ 100&#xa0;ms. A Day-1 ECG risk score provides a simple bedside tool to optimize discharge strategies.</p> Graphical Abstract <p></p>

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Impact of early PR interval prolongation after transcatheter aortic valve Implantation (TAVI) on the onset of high-grade conduction disturbances

  • 期刊论文

  • 发表日期：

    2025年12月1日

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  • Grégoire Massoullie,
  • Marion Bouchant-Pioche,
  • Bruno Pereira,
  • Antoine Boudias,
  • Géraud Souteyrand,
  • Pierre-Antoine Catalan,
  • Saer Abu-Alrub,
  • Nicolas Combaret,
  • Guillaume Clerfond,
  • Romain Eschalier

摘要

Background and aims

High-grade atrioventricular conduction disorders or blocks (HAVB) are common complications following Transcatheter Aortic Valve Implantation (TAVI). This study aimed to evaluate the incidence and prognostic significance of PR interval prolongation at Day 1 (D1) after TAVI on the risk of HAVB and pacemaker implantation (PPI).

Methods

This is a single-center retrospective cohort including 1151 patients who underwent TAVI from January 2010 to December 2020. PR interval prolongation was measured between pre-TAVI and D1 ECG. The primary endpoint was HAVB leading to PPI at 10 days. Based on multivariable model, Day-1 ECG risk score was developed using PR, QRS duration and valve type.

Results

The mean PR interval prolongation at D1 was 8 ± 28 ms, 20.8% developed a type 1 AV block. A PR-interval prolongation ≥ 40 ms at Day 1 was an independent predictor of HAVB requiring PPI in patients with QRS ≥ 100 ms (HR = 2.8 [1.8–4.1], p < 0.001), with a 10-day incidence of 39.2%, compared with 7.0% in those with QRS < 100 ms (p < 0.001). The Day-1 ECG risk score classified patients according to increasing 10-day HAVB rates of 5.4%, 17.7%, and 32.7% in the low-, intermediate-, and high-risk groups, respectively (p < 0.001).

Conclusions

PR interval prolongation ≥ 40 ms at D1 after Transcatheter Aortic Valve Implantation is a strong predictor of high-grade atrioventricular conduction disorders or blocks requiring pacemaker implantation, particularly in patients with QRS ≥ 100 ms. A Day-1 ECG risk score provides a simple bedside tool to optimize discharge strategies.

Graphical Abstract