Monitoring conduction disturbances following TAVR: Feasibility study of early discharge using a novel telemetry patch

Andrea Scotti, Matteo Sturla, Augustin Coisne, Manaf Assafin, Mei Chau, Edwin C.W. Ho, Juan F. Granada, Kevin J. Ferrick, Luigi Di Biase, Azeem Latib

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Despite the technological advances and increasing operator experience, the rate of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) has not decreased over time. With a continuous downward trend in post-TAVR length of stay, prolonged home-monitoring may have a key role in detecting potentially serious conduction abnormalities after TAVR discharge. Methods: In this study, the ZioPatch-AT monitor was used to detect conduction abnormalities after TAVR discharge. The cardiac monitoring device was systematically provided to all patients having pre-existing right bundle branch block or developing intra−/peri-procedural conduction disturbances, in the absence of guideline indication for PPI at discharge. Results: From a total of 75 patients at high-risk of conduction disturbances, 8 (11%) of them underwent PPI and most of them (6/8) were detected before symptoms' occurrence. Paired analysis between baseline and discharge electrocardiograms detected a significant widening of the QRS in all patients; on the contrary, PR length was significantly increased only in the group experiencing HAVB after discharge (p < 0.01). Conclusions: In an early post-TAVR discharge era, 30-day outpatient cardiac rhythm monitoring is potentially a safe solution to allow timely recognition of new conduction disturbances requiring PPI.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - 2022

Keywords

  • Cardiac monitoring
  • Early discharge
  • Permanent pacemaker implantation
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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