Conclusions Systematic identification of new-onset arrhythmias following TAVI may have considerable impact on subsequent therapeutic management and long-term prognosis in this patient population
Objective To evaluate the prevalence and clinical impact of new-onset arrhythmias in patients following transcatheter aortic valve implantation ( TAVI ) .
Excellent outcomes for transcatheter aortic valve replacement within 1 year of opening a low-volume centre and consideration of requirements.
BACKGROUND After the approval of transcatheter aortic valve replacement ( TAVR ) for high-risk or inoperable patients with severe aortic stenosis ( AS ) , many low- and moderate-volume TAVR programs were initiated . Contemporary outcomes from these newly initiated centres remain unknown . METHODS In March 2013 , our institution was authorized by the Québec Ministry of Health to perform 30 TAVR procedures .  After thorough clinical screening and imaging evaluation , suitable patients underwent transfemoral TAVR with the balloon-exp and able SAPIEN XT ( Edwards Lifesciences , Irvine , CA ) transcatheter heart valve ( THV ) . In-hospital and 30-day outcomes were prospect ively collected and reported according to Valve Academic Research Consortium 2 guidelines . RESULTS From April 2013 to January 2014 , 30 consecutive high-risk ( n = 16 [ 53.3 % ] ) or inoperable ( n = 14 [ 46.7 % ] ) patients ( mean age , 84.6 years ; mean Society of Thoracic Surgery score , 7 ) with symptomatic severe AS underwent transfemoral TAVR . No catastrophic intraprocedural complications such as annulus rupture , valve embolization , aortic dissection , or coronary occlusion occurred , and there were no deaths at 30 days . Disabling stroke occurred in 1 ( 3.3 % ) patient 48 hours after THV implantation . Major vascular complications and major bleeding occurred in 1 ( 3.3 % ) patient . No moderate or severe paravalvular leak was observed . The median length of stay was 2 ( 1 - 3 ) days , with 8 ( 26.7 % ) patients discharged within 24 hours after the procedure . CONCLUSIONS Excellent outcomes can be achieved in newly initiated relatively low-volume centres , which compares favorably to previously published large series . Important considerations include appropriate team training , rigorous patient screening , use of multimodality imaging techniques , a heart team approach , constant integration of lessons learned from larger published experiences , and maintaining a recommended minimum volume of 25 cases per year
Conclusions Systematic identification of new-onset arrhythmias following TAVI may have considerable impact on subsequent therapeutic management and long-term prognosis in this patient population
Objective To evaluate the prevalence and clinical impact of new-onset arrhythmias in patients following transcatheter aortic valve implantation ( TAVI ) .