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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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05. Atrial Fibrillation
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Unmet needs in transcatheter aortic valve replacement: a novel telemetry patch for monitoring conduction disturbances
Session:
Sessão de Posters 23 - Pacing após TAVI
Speaker:
Sofia B. Paula
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Sofia B. Paula; Margarida Figueiredo; Sandra Alves; Sofia Jacinto; Ana Raquel Santos; Hélder Santos; Paulo Osório; Guilherme Portugal; Bruno Valente; Ana Lousinha; Pedro Silva Cunha; Mário Oliveira
Abstract
<p><span style="font-size:12.5pt"><span style="background-color:white"><span style="font-family:"Calibri",sans-serif"><span style="color:black">Despite technical advances and operator experience, the rate of patients requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) has not decreased. With the continuous downward trend in post-TAVR length of hospital stay, </span></span></span></span><span style="font-size:12.5pt"><span style="font-family:"Calibri",sans-serif"><span style="color:black">ambulatory electrocardiographic (AECG) monitoring during the early post-discharge period has emerged as a useful tool for the diagnosis and treatment of delayed arrhythmic events following TAVR. <strong>Methods: </strong><span style="background-color:white">Single-centre retrospective study aiming to detect rhythm abnormalities after TAVR discharge. Monitoring of these patients was achieved using the ePatch continuous monitoring, implanted at the moment of discharge after TAVR (4-5 days in-hospital stay). The cardiac monitoring system was systematically provided to patients developing slight intra−/peri-procedural conduction disturbances, without guideline indication for PPI at discharge. Data was collected between August 2022 and August 2023. </span><strong>Results: </strong>We included a total of 27 patients, mean age 82.2 (±7.8) years, 55.6% female. In baseline, 66.7% were in sinus rhythm and 33,3% in atrial fibrillation. Mean recording time was 111.3 (±27.3) hours, with a mean heart rate (HR) of 73.6 (±9.9) bpm. During the AECG monitoring, 33.3% and 3.7% of the patients developed new onset LBBB and RBBB, respectively. <span style="background-color:white">Paired analysis between baseline and post-discharge recordings detected a significant widening of the QRS and PR interval in these patients (114ms vs. 135ms; p<0.001, and 192ms vs. 237ms; p<0.001, respectively). Significant sinus pauses were identified in </span>40.7% of the patients, from which 3 cases had pauses > 3s. A<span style="background-color:white">lternating bundle branch block</span> and 1<sup>st</sup>-degree atrioventricular block <span style="background-color:white">were detected in 4 patients who underwent </span>PPI afterwards. In one patient, AF episodes were detected with a burden of 3% and high-rate periods. Another case had numerous episodes of self-limited ventricular tachycardia and was admitted for ICD implantation. In total, AECG showed clinically relevant rhythm abnormalities in >50% of the patients after TAVR, with 5 out of 27 patients receiving an implantable electronic device. <strong>Conclusion: </strong><span style="background-color:white">Early outpatient cardiac rhythm monitoring using an E-patch is a safe solution to allow timely recognition of conduction and rhythm disturbances requiring PPI or other devices. </span></span></span></span></p>
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