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首页> 外文期刊>The American Journal of Cardiology >Long-Term Electrocardiographic Changes and Clinical Outcomes of Transcatheter Aortic Valve Implantation Recipients Without New Postprocedural Conduction Disturbances
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Long-Term Electrocardiographic Changes and Clinical Outcomes of Transcatheter Aortic Valve Implantation Recipients Without New Postprocedural Conduction Disturbances

机译：无线电经历导通障碍的长期心电图植入接受者的长期心电图变化和临床结果

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The objective of this study was to determine the long-term (>1 year) electrocardiographic (ECG) and clinical outcomes of patients without significant changes in their electrocardiogram after transcatheter aortic valve implantation (TAVI; including patients with preexisting ECG abnormalities). Among 772 consecutive patients who underwent TAVI in our institution, 397 patients (51%) without new ECG changes were included. TAVI patients were divided into 2 groups according to the presence of pre-existing ECG-conduction disturbances (ECG-CD: 140 patients, non-ECG-CD: 257 patients). Clinical follow-up (median: 35 [22 to 57] months) was complete in all patients but 5 (1.2%), and ECG data were available in 291 patients (84.3% of patients at risk) at a median of 29 (20 to 50) months. In the non-ECG-CD group, most patients (79.8%) remained without significant ECG changes at follow-up, and 16.9% developed first-degree atrioventricular block and/or bundle branch block over time. The rate of permanent pacemaker (PPM) implantation at follow-up was 3.5% (1.1%/year) in the non-ECG-CD group versus 15.7% (5.5%/year) in the ECG-CD group (p <0.001). The presence of pre-existing CD was an independent predictor of PPM at follow-up (hazard ratio [HR] 4.67, 95% confidence interval [CI] 2.15 to 10.16, p <0.001). The ECG-CD group exhibited a higher risk of heart failure hospitalization (non-ECG-CD: 25%, ECG-CD: 29%, log-rank p = 0.01), but not mortality (non-ECG-CD: 50%, ECG-CD: 46%, log-rank p = 0.60) at 5-year follow-up. In conclusion, the ECG remained unchanged in most TAVI recipients without new postprocedural CD. Pre-existing ECG-CD was associated with an increased risk of PPM and heart failure hospitalization at long-term follow-up. These results provide reassuring data in the era of TAVI expanding toward candidates with a longer life expectancy, and highlight the importance of a closer follow- up of those patients with pre-existing ECG-CDs. (C) 2019 Elsevier Inc. All rights reserved.
机译：本研究的目的是确定长期（> 1年）心电图（ECG）和患者的临床结果，无需经齿轮管主动脉瓣植入（TAVI;包括预先存在的ECG异常的患者）的心电图。在我们所在机构接受Tavi的连续772名患者中，包括397名患者（51％），没有新的ECG变化。根据预先存在的心电图传导干扰的存在，Tavi患者分为2组（ECG-CD：140名患者，非ECG-CD：257名患者）。临床随访（中位数：35 [22至57]个月）在所有患者中完成，但在291名患者（风险84.3％的患者）中有291名（危险的84.3％）和ECG数据（20到50）个月。在非ECG-CD组中，大多数患者（79.8％）仍然没有显着的ECG变化，随后的16.9％开发了一级房室间块和/或捆绑分支块。随访中的永久性起搏器（PPM）植入率为3.5％（1.1％/年），在非ECG-CD组，ECG-CD组中为15.7％（5.5％/年）（P <0.001） 。预先存在的Cd的存在是后续预测PPM的独立预测因子（危险比[HR] 4.67,95％置信区间[CI] 2.15至10.16，P <0.001）。 ECG-CD组的心力衰竭住院风险较高（非ECG-CD：25％，ECG-CD：29％，Log-Rank P = 0.01），但不是死亡率（非ECG-CD：50％ ，ECG-CD：46％，日志排名P = 0.60）在5年的随访时间。总之，在没有新的后期CD的情况下，ECG在大多数TAVI受助人中保持不变。预先存在的ECG-CD与长期随访的PPM和心力衰竭住院风险增加有关。这些结果提供了向候选人的Tavi时代向候选人扩展的时代的数据，并突出了这些患者预先存在的ECG-CD患者的重要性。 （c）2019 Elsevier Inc.保留所有权利。

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