Predictive role of ventricular repolarization parameters for the occurrence of complete heart block in patients undergoing transcatheter aortic valve implantation

Abstract

Background We investigated the role of ventricular repolarization parameters to predict complete atrioventricular block in patients undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 150 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned in two groups based on the presence (n: 49) or absence (n: 101) of complete atrioventricular block after TAVI. Ventricular repolarization intervals (QT, QTc, JT, JTc, TP-E), indices (QT dispersion), and ratios (TP-E/QT, TP-E/QTc, TP-E/JTc) were measured. Results Electrocardiographic repolarization parameters such as Tp-e interval: 74.2 +/- 5.1 versus 59.2 +/- 6.1 ms,p < .001; QTc interval: 397.6 +/- 3.4 versus 368.1 +/- 7.8 ms,p < .001; JTc interval: 317.4 +/- 11.3 versus 291.1 +/- 6.7 ms,p < .001; Tp-e/QT ratio: 0.28 +/- 0.04 versus 0.20 +/- 0.04,p < .001; Tp-e/QTc ratio: 0.29 +/- 0.04 versus 0.19 +/- 0.03,p < .001; Tp-e/JT ratio: 0.32 +/- 0.03 versus 0.23 +/- 0.03,p < .001; Tp-e/JTc ratio: 0.30 +/- 0.02 versus 0.2 +/- 0.03,p < .001; and QT dispersion: 34.4 +/- 3.0 versus 17.8 +/- 3.6 ms,p < .01 were significantly higher in post-TAVI permanent pacemaker group. In a univariate regression analysis, pulmonary artery pressure, heart rate, coronary artery disease, Tp-e/QTc, Tp-e/JTc, and PR interval were significantly associated with complete heart block. Tp-e/JTc (OR 0.373,p = .067) and PR interval (OR 0.898,p = .079) were found to be independent predictors of these type of arrhythmias in a multivariate analysis. But it is not statistically significant. Conclusion Our results suggest that repolarization parameters may play a role in predicting complete atrioventricular block. Tp-e/JTc was found to be potential independent risk marker for this setting.