Atrioventricular Block After EVOQUE Transcatheter Tricuspid Valve Replacement.

IF 2.8
Structural heart : the journal of the Heart Team Pub Date : 2025-07-16 eCollection Date: 2025-09-01 DOI:10.1016/j.shj.2025.100701
Gautam Rangavajla, Ritik Patel, Felix Nguyen, Brian Vickers, Omar Abdelhai, Brian La Starza, Karl Ilg, Waddah Maskoun, Matthew Ebinger, Marc Lahiri, Arfaat Khan, Josh Greenberg, Georgi Fram, Hussayn Alrayes, Leo Kar Lok Lai, Janet Wyman, Sachin Parikh, Bryan Zweig, John Dawdy, Nathaniel Bowerman, Pedro Engel Gonzalez, William O'Neill, Pedro Villablanca, James Lee, Brian P O'Neill, Mohamad Raad, Tiberio M Frisoli
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Abstract

•Based on a real-world study of 106 Evoque transcatheter tricuspid valve replacement (TTVR) recipients, a total of 14 (25%) cases of new atrioventricular (AV) block occurred after Evoque implantation in the 55 patients without prior pacemakers who met study inclusion criteria. This incidence is similar to that reported in the TRISCEND II clinical trial.•New AV block occurred in a median of 26 hours after Evoque TTVR (interquartile range: 5-60 hours), but there were cases of new AV block that occurred as late as 7 days after the procedure.•Of the 14 new cases of AV block, 12 were treated successfully with implantation of a leadless pacemaker (Micra) under fluoroscopic guidance without procedural complications or compromising the valve implantation.•The institutional strategy of 48-hour post-Evoque inpatient monitoring for all patients followed by mobile cardiac outpatient telemetry identified 11 of 14 cases of new AV block as before discharge from the hospital and 1 case as an outpatient before symptom onset.

Abstract Image

EVOQUE经导管三尖瓣置换术后房室传导阻滞。
•基于106例Evoque经导管三尖瓣置换术(TTVR)受者的真实世界研究,在符合研究纳入标准的55例无起搏器的患者中,Evoque植入后共发生14例(25%)新的房室(AV)传导阻滞。这一发生率与TRISCEND II临床试验报告的发生率相似。•Evoque TTVR术后中位26小时出现新的房室传导阻滞(四分位数范围:5-60小时),但也有病例在手术后7天出现新的房室传导阻滞。•在14例新的房室传导阻滞病例中,12例在透视引导下成功植入无导联起搏器(Micra),无手术并发症或影响瓣膜植入。•evoque术后对所有患者进行48小时住院监测,然后进行移动心脏门诊遥测的机构策略确定了14例新房室传导阻滞中的11例在出院前,1例在症状出现前门诊。
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