Temporal trends in conduction disturbances during hospital stay following transcatheter aortic valve implantation (TAVI)

There is limited data on the usefulness of continuous electrocardiographic (ECG) monitoring post-transcatheter aortic valve implantation (TAVI). This study describes temporal trends in ECG of TAVI patients during their post procedural hospital stay. Methods: Study population included patients who underwent TAVI and had their ECG documented in at least 4 time points during their hospital stay: baseline, post-procedure, post-procedural days 1-2 and post-procedural days 3-7. ECG data included PR QRS QT and QTc intervals as well as RBBB and LBBB conduction disturbances. Ventricular-paced ECG were excluded from the analysis. Results: Final study population included 327 patients (study period 2008-2019). Mean age of the study population was 82±7 and 144 (44%) were males. Self-expanding valve used utilized in 160 patients and balloon expandable valves were utilized in 103 patients. Thirty three (10%) patients received permanent pacemaker following the procedure. There were 108 new LBBB cases of which 3 resolved on day 2-3 and additional 2 resolved on day 4-7. Significant temporal changes were documented in QRS duration and PR interval (Figure) (pCorrected QT intervals also changed during hospital stay: from a baseline of 476±51 milliseconds to 495±41 post procedure (p<.001) and then to 483±39 and 482±45 on days 2-3 and 4-7 respectively (pConclusion: New LBBB is frequent, and once occurs it does not resolve in the vast majority of the patients. Patients who experience PR and/or QRS prolongation after TAVI should be monitored for >4 days as further prolongation may occur late in the hospital course.