{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:26:11Z","timestamp":1793298371979,"version":"4.5.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T00:00:00Z","timestamp":1674259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T00:00:00Z","timestamp":1674259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>Transcatheter aortic valve replacement (TAVR) can cause intraventricular conduction disturbances (ICA), particularly left bundle branch block (BBB) and high-degree atrioventricular block (HAVB). The aim of this study was to investigate clinical, anatomical, procedural, and electrophysiological parameters predicting ICA after TAVR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with severe aortic stenosis (<jats:italic>n<\/jats:italic>\u2009=\u2009203) without pacing devices undergoing TAVR with a self-expanding (<jats:italic>n<\/jats:italic>\u2009=\u2009103) or balloon-expanding (<jats:italic>n<\/jats:italic>\u2009=\u2009100) valve were enrolled. Clinical and anatomical parameters, such as length of the membranous septum (MS) and implantation depth, were assessed. His-ventricular interval (HVi) before and after implantation was determined. 12-lead-electrocardiograms (ECG) before, during and after 3 and 30\u00a0days after TAVR were analyzed for detection of any ICA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 203 consecutive patients (aortic valve area 0.78\u2009\u00b1\u20090.18 cm<jats:sup>2<\/jats:sup>,  age 80\u2009\u00b1\u20096\u00a0years, 54% male, left ventricular ejection fraction 52\u2009\u00b1\u200910%), TAVR led to a significant prolongation of infranodal conduction in all patients from 49\u2009\u00b1\u200910\u00a0ms to 59\u2009\u00b1\u200916\u00a0ms (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). The HVi prolongation was independent of valve types, occurrence of HAVB or ICA. Fifteen patients (7%) developed HAVB requiring permanent pacemaker (PPM) implantation and 63 patients (31%) developed ICA within 30\u00a0days. Pre-existing BBB (OR 11.64; 95% CI 2.87\u201347.20; <jats:italic>p<\/jats:italic>\u2009=\u20090.001), new-onset left BBB (OR 15.72; 95% CI 3.05\u201381.03; <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and diabetes mellitus (OR 3.88; 95% CI 1.30\u201315.99; <jats:italic>p<\/jats:italic>\u2009=\u20090.02) independently predicted HAVB requiring PPM. Neither pre-existing right BBB, a prolonged postHVi, increases in PR duration, any of the TAVR implantation procedural and anatomic nor echocardiographic characteristics were predictive for later HAVB.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>New-onset left BBB and diabetes mellitus independently predicted HAVB requiring PPM after TAVR and helped to identify patients at risk. Electrophysiologic study (EPS) of atrioventricular conduction was neither specific nor predictive of HAVB and can be skipped.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration number<\/jats:title>\n                <jats:p>NCT04128384 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-023-02160-0","type":"journal-article","created":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T12:02:29Z","timestamp":1674302549000},"page":"677-690","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prediction of conduction disturbances in patients undergoing transcatheter aortic valve replacement"],"prefix":"10.1007","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3758-4586","authenticated-orcid":false,"given":"Val\u00e9rie","family":"Pavlicek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Mahfoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Bubel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ewen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Scheller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Ukena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,21]]},"reference":[{"issue":"6","key":"2160_CR1","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.rec.2022.05.006","volume":"75","author":"A Vahanian","year":"2022","unstructured":"Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, J\u00fcni P, Pierard L, Prendergast BD, S\u00e1daba JR, Tribouilloy C, Wojakowski W (2022) 2021 ESC\/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). 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SE has received speaker honoraria from Medtronic, Recor, Bayer, Daiichi Sankyo, Novartis, AstraZeneca, Akcea Therapeutics and Pfizer. MB has received scientific support and speaker honoraria from Abbot, Amgen, Bayer, Boehringer Ingelheim, Medtronic, Novartis, Servier and ReCor Medical. CU has received scientific support and speaker Honoria from Bayer, Pfizer, Medtronic, and ReCor Medical. All other authors have no conflict of interest to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The trial was approved by the Ethics Committee of the Saarland University. The trial was performed in accordance with the principles of the Declaration of Helsinki. All patients provided written informed consent prior to inclusion in the trial. The trial was registered at  (NCT04128384).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}