His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block
Transcatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a hi...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2018/4606271 |
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| author | Jonathan Sen Michael Mok Mark Perrin |
| author_facet | Jonathan Sen Michael Mok Mark Perrin |
| author_sort | Jonathan Sen |
| collection | DOAJ |
| description | Transcatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a higher risk of cardiovascular morbidity and mortality. His-bundle pacing (HBP) may be useful to treat TAVI-induced LBBB but has yet to be reported. We present the case of a 76-year-old man with severe symptomatic aortic stenosis treated with TAVI. His preoperative electrocardiogram showed sinus rhythm with a narrow QRS complex. Insertion of a CoreValve Evolut R transcatheter aortic valve was uneventful apart from the development of LBBB with a long PR interval. A dual-lead DDD pacemaker was implanted via the left cephalic vein on the following day. HV was mildly prolonged at 60 ms. Capture of the proximal His restored AV synchrony without correction of LBBB. Repositioning of the lead with capture of the left bundle branch enabled complete ventricular resynchronisation with a single lead. Our case demonstrates that LBBB in the setting of TAVI may be corrected by HBP. |
| format | Article |
| id | doaj-art-8e08957edeab4e6092fc354312444904 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-8e08957edeab4e6092fc3543124449042025-02-03T06:13:37ZengWileyCase Reports in Cardiology2090-64042090-64122018-01-01201810.1155/2018/46062714606271His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch BlockJonathan Sen0Michael Mok1Mark Perrin2University Hospital Geelong, Barwon Health, PO Box 281, Geelong, VIC 3220, AustraliaUniversity Hospital Geelong, Barwon Health, PO Box 281, Geelong, VIC 3220, AustraliaUniversity Hospital Geelong, Barwon Health, PO Box 281, Geelong, VIC 3220, AustraliaTranscatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a higher risk of cardiovascular morbidity and mortality. His-bundle pacing (HBP) may be useful to treat TAVI-induced LBBB but has yet to be reported. We present the case of a 76-year-old man with severe symptomatic aortic stenosis treated with TAVI. His preoperative electrocardiogram showed sinus rhythm with a narrow QRS complex. Insertion of a CoreValve Evolut R transcatheter aortic valve was uneventful apart from the development of LBBB with a long PR interval. A dual-lead DDD pacemaker was implanted via the left cephalic vein on the following day. HV was mildly prolonged at 60 ms. Capture of the proximal His restored AV synchrony without correction of LBBB. Repositioning of the lead with capture of the left bundle branch enabled complete ventricular resynchronisation with a single lead. Our case demonstrates that LBBB in the setting of TAVI may be corrected by HBP.http://dx.doi.org/10.1155/2018/4606271 |
| spellingShingle | Jonathan Sen Michael Mok Mark Perrin His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block Case Reports in Cardiology |
| title | His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block |
| title_full | His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block |
| title_fullStr | His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block |
| title_full_unstemmed | His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block |
| title_short | His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block |
| title_sort | his bundle pacing in a patient with transcatheter aortic valve implantation induced left bundle branch block |
| url | http://dx.doi.org/10.1155/2018/4606271 |
| work_keys_str_mv | AT jonathansen hisbundlepacinginapatientwithtranscatheteraorticvalveimplantationinducedleftbundlebranchblock AT michaelmok hisbundlepacinginapatientwithtranscatheteraorticvalveimplantationinducedleftbundlebranchblock AT markperrin hisbundlepacinginapatientwithtranscatheteraorticvalveimplantationinducedleftbundlebranchblock |