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Nuis RJ, Turgut G, van der Boon RM, et al. Defective recovery of QT dispersion following transcatheter aortic valve implantation: frequency, predictors and prognosis. J Geriatr Cardiol. 2015;12(5):482-8doi: 10.11909/j.issn.1671-5411.2015.05.016.
Nuis, R. J., Turgut, G., van der Boon, R. M., van Mieghem, N. M., Nauta, S. T., Serruys, P. W., van Domburg, R. T., Zuchelli, G., Jordaens, L., & de Jaegere, P. P. (2015). Defective recovery of QT dispersion following transcatheter aortic valve implantation: frequency, predictors and prognosis. Journal of geriatric cardiology : JGC, 12(5), 482-8. https://doi.org/10.11909/j.issn.1671-5411.2015.05.016
Nuis, Rutger-Jan, et al. "Defective recovery of QT dispersion following transcatheter aortic valve implantation: frequency, predictors and prognosis." Journal of geriatric cardiology : JGC vol. 12,5 (2015): 482-8. doi: https://doi.org/10.11909/j.issn.1671-5411.2015.05.016
Nuis RJ, Turgut G, van der Boon RM, van Mieghem NM, Nauta ST, Serruys PW, van Domburg RT, Zuchelli G, Jordaens L, de Jaegere PP. Defective recovery of QT dispersion following transcatheter aortic valve implantation: frequency, predictors and prognosis. J Geriatr Cardiol. 2015 Sep;12(5):482-8. doi: 10.11909/j.issn.1671-5411.2015.05.016. PMID: 26512238; PMCID: PMC4605942.
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J Geriatr Cardiol. 2015 Sep;12(5):482-8. doi: 10.11909/j.issn.1671-5411.2015.05.016.

Defective recovery of QT dispersion following transcatheter aortic valve implantation: frequency, predictors and prognosis.

Journal of geriatric cardiology : JGC

Rutger-Jan Nuis, Gokhan Turgut, Robert M van der Boon, Nicolas M van Mieghem, Sjoerd T Nauta, Patrick W Serruys, Ron T van Domburg, Giulio Zuchelli, Luc Jordaens, Peter P de Jaegere

Affiliations

  1. Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  2. Department of Electrophysiology, Erasmus Thoraxcenter, Rotterdam, the Netherlands.
  3. Department of Biostatistics, Erasmus Thoraxcenter, Rotterdam, the Netherlands.
  4. Division of Cardiovascular Diseases, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

PMID: 26512238 PMCID: PMC4605942 DOI: 10.11909/j.issn.1671-5411.2015.05.016

Abstract

BACKGROUND: Corrected QT dispersion (cQTD) has been correlated with non-uniform ventricular repolarisation and increased mortality. In patients with aortic stenosis, cQTD has been shown improved after surgical valve replacement, but the effects of transcatheter aortic valve implantation (TAVI) are unknown. Therefore, we sought to explore the frequency, predictors and prognostic effects of defective cQTD recovery at 6 months after TAVI.

METHODS: A total of 222 patients underwent TAVI with the Medtronic-CoreValve System between November 2005 and January 2012. Patients who were on class I or III antiarrhythmics or on chronic haemodialysis or who developed atrial fibrillation, a new bundle branch block or became pacemaker dependent after TAVI were excluded. As a result, pre-, post- and follow-up ECG (median: 6 months) analysis was available in 45 eligible patients. Defective cQTD recovery was defined as any progression beyond the baseline cQTD at 6 months.

RESULTS: In the 45 patients, the mean cQTD was 47 ± 23 ms at baseline, 45 ± 17 ms immediately after TAVI and 40 ± 16 ms at 6 months (15% reduction, P = 0.049). Compared to baseline, cQTD at 6 months was improved in 60% of the patients whereas defective cQTD recovery was present in 40%. cQTD increase immediately after TAVI was an independent predictor of defective cQTD recovery at 6 months (per 10 ms increase; OR: 1.89, 95% CI: 1.15-3.12). By univariable analysis, defective cQTD recovery was associated with late mortality (HR: 1.52, 95% CI: 1.05-2.17).

CONCLUSIONS: Despite a gradual reduction of cQTD after TAVI, 40% of the patients had defective recovery at 6 months which was associated with late mortality. More detailed ECG analysis after TAVI may help to avoid late death.

Keywords: Aortic stenosis; Conduction abnormalities; Left bundle branch block; Predictors; QT dispersion; Transcatheter aortic valve implantation

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