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Erschienen in: Heart and Vessels 9/2017

20.03.2017 | Original Article

A longer total duration of rapid ventricular pacing does not increase the risk of postprocedural myocardial injury in patients who undergo transcatheter aortic valve implantation

verfasst von: Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Mitsuo Iwasaki, Sho Carl Shibata, Yuji Fujino

Erschienen in: Heart and Vessels | Ausgabe 9/2017

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Abstract

Rapid ventricular pacing (RVP) is used during transcatheter aortic valve implantation (TAVI). RVP disturbs myocardial oxygen balance, and when prolonged, it may cause procedure-related myocardial injury (PMI). This study investigated whether a longer duration of RVP increased the occurrence of PMI or worsened long-term mortality after TAVI. We retrospectively analyzed data from 188 patients who underwent TAVI in our institute from January 2013 to July 2015. Myocardial injury was represented by the peak value of creatine kinase-myocardial band (CK-MB) within 72 h after the procedure; an increase greater than 5 times the upper reference limit was regarded as PMI. There was no difference in RVP time (RVPT) between patients with and without PMI (median [range]: 57 [9–189] s vs. 54 [0–159] s, p = 0.9). A higher peak CK-MB was significantly correlated with the apical approach for the procedure (p < 0.001) but not with total RVPT (p = 0.22). A subanalysis of 133 patients whose troponin I was tested within 72 h postprocedurally showed no correlation between the peak value and RVPT (p = 0.40). Shortening RVPT did not result in myocardial protection; thus, RVPT during TAVI should be sufficient to optimize valve placement.
Literatur
1.
Zurück zum Zitat Paradis JM, Maniar HS, Lasala JM, Kodali S, Williams M, Lindman BR, Damiano RJ, Moon MR, Makkar RR, Thourani VH, Babaliaros V, Xu K, Ayele GM, Svensson L, Leon MB, Zajarias A (2015) Clinical and functional outcomes associated with myocardial injury after transfemoral and transapical transcatheter aortic valve replacement: a subanalysis from the PARTNER Trial (Placement of Aortic Transcatheter Valves). JACC Cardiovasc Interv 8:1468–1479CrossRefPubMedPubMedCentral Paradis JM, Maniar HS, Lasala JM, Kodali S, Williams M, Lindman BR, Damiano RJ, Moon MR, Makkar RR, Thourani VH, Babaliaros V, Xu K, Ayele GM, Svensson L, Leon MB, Zajarias A (2015) Clinical and functional outcomes associated with myocardial injury after transfemoral and transapical transcatheter aortic valve replacement: a subanalysis from the PARTNER Trial (Placement of Aortic Transcatheter Valves). JACC Cardiovasc Interv 8:1468–1479CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Lauten A, Figulla HR, Möllmann H, Holzhey D, Kötting J, Beckmann A, Veit C, Cremer J, Kuck KH, Lange R, Zahn R, Sack S, Schuler G, Walther T, Beyersdorf F, Böhm M, Heusch G, Meinertz T, Neumann T, Welz A, Mohr FW, Hamm CW; GARY Executive Board (2014) TAVI for low-flow, low-gradient severe aortic stenosis with preserved or reduced ejection fraction: a subgroup analysis from the German Aortic Valve Registry (GARY). EuroIntervention 10:850–859.CrossRefPubMed Lauten A, Figulla HR, Möllmann H, Holzhey D, Kötting J, Beckmann A, Veit C, Cremer J, Kuck KH, Lange R, Zahn R, Sack S, Schuler G, Walther T, Beyersdorf F, Böhm M, Heusch G, Meinertz T, Neumann T, Welz A, Mohr FW, Hamm CW; GARY Executive Board (2014) TAVI for low-flow, low-gradient severe aortic stenosis with preserved or reduced ejection fraction: a subgroup analysis from the German Aortic Valve Registry (GARY). EuroIntervention 10:850–859.CrossRefPubMed
3.
Zurück zum Zitat Franco A, Gerli C, Ruggeri L, Monaco F (2012) Anaesthetic management of transcatheter aortic valve implantation. Ann Cardiac Anaesth 15:54–63CrossRef Franco A, Gerli C, Ruggeri L, Monaco F (2012) Anaesthetic management of transcatheter aortic valve implantation. Ann Cardiac Anaesth 15:54–63CrossRef
4.
Zurück zum Zitat Witzke C, Don CW, Cubeddu RJ, Herrero-Garibi J, Pomerantsev E, Caldera A, McCarty D, Inglessis I, Palacios IF (2010) Impact of rapid ventricular pacing during percutaneous balloon aortic valvuloplasty in patients with critical aortic stenosis: should we be using it? Catheter Cardiovasc Interv 75:444–452PubMed Witzke C, Don CW, Cubeddu RJ, Herrero-Garibi J, Pomerantsev E, Caldera A, McCarty D, Inglessis I, Palacios IF (2010) Impact of rapid ventricular pacing during percutaneous balloon aortic valvuloplasty in patients with critical aortic stenosis: should we be using it? Catheter Cardiovasc Interv 75:444–452PubMed
5.
Zurück zum Zitat Kahlert P, Al-Rashid F, Plicht B, Wild C, Westhölter D, Hildebrandt H, Baars T, Neumann T, Nensa F, Nassenstein K, Wendt D, Thielmann M, Jakob H, Kottenberg E, Peters J, Erbel R, Heusch G (2016) Myocardial injury during transfemoral transcatheter aortic valve implantation: an intracoronary Doppler and cardiac magnetic resonance imaging study. EuroIntervention 11:1401–1408CrossRefPubMed Kahlert P, Al-Rashid F, Plicht B, Wild C, Westhölter D, Hildebrandt H, Baars T, Neumann T, Nensa F, Nassenstein K, Wendt D, Thielmann M, Jakob H, Kottenberg E, Peters J, Erbel R, Heusch G (2016) Myocardial injury during transfemoral transcatheter aortic valve implantation: an intracoronary Doppler and cardiac magnetic resonance imaging study. EuroIntervention 11:1401–1408CrossRefPubMed
6.
Zurück zum Zitat Chorianopoulos E, Krumsdorf U, Geis N, Pleger ST, Giannitsis E, Katus HA, Bekeredjian R (2014) Preserved prognostic value of preinterventional troponin T levels despite successful TAVI in patients with severe aortic stenosis. Clin Res Cardiol 103:65–72CrossRefPubMed Chorianopoulos E, Krumsdorf U, Geis N, Pleger ST, Giannitsis E, Katus HA, Bekeredjian R (2014) Preserved prognostic value of preinterventional troponin T levels despite successful TAVI in patients with severe aortic stenosis. Clin Res Cardiol 103:65–72CrossRefPubMed
7.
Zurück zum Zitat Dumont E, Rodés-Cabau J, De LaRochellière R, Lemieux J, Villeneuve J, Doyle D (2009) Rapid pacing technique for preventing ventricular tears during transapical aortic valve replacement. J Cardiac Surg 24:295–298CrossRef Dumont E, Rodés-Cabau J, De LaRochellière R, Lemieux J, Villeneuve J, Doyle D (2009) Rapid pacing technique for preventing ventricular tears during transapical aortic valve replacement. J Cardiac Surg 24:295–298CrossRef
8.
Zurück zum Zitat Kappetein AP, Head SJ, Généreux P, Piazza N, van Mieghem NM, Blackstone EH, Brott TG, Cohen DJ, Cutlip DE, van Es GA, Hahn RT, Kirtane AJ, Krucoff MW, Kodali S, Mack MJ, Mehran R, Rodés-Cabau J, Vranckx P, Webb JG, Windecker S, Serruys PW, Leon MB (2012) Valve Academic Research Consortium-2. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. Eur Heart J 33:2403–2418CrossRef Kappetein AP, Head SJ, Généreux P, Piazza N, van Mieghem NM, Blackstone EH, Brott TG, Cohen DJ, Cutlip DE, van Es GA, Hahn RT, Kirtane AJ, Krucoff MW, Kodali S, Mack MJ, Mehran R, Rodés-Cabau J, Vranckx P, Webb JG, Windecker S, Serruys PW, Leon MB (2012) Valve Academic Research Consortium-2. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. Eur Heart J 33:2403–2418CrossRef
9.
Zurück zum Zitat Barbash IM, Dvir D, Ben-Dor I, Badr S, Okubagzi P, Torguson R, Corso PJ, Xue Z, Satler LF, Pichard AD, Waksman R (2013) Prevalence and effect of myocardial injury after transcatheter aortic valve replacement. Am J Cardiol 111:1337–1343CrossRefPubMed Barbash IM, Dvir D, Ben-Dor I, Badr S, Okubagzi P, Torguson R, Corso PJ, Xue Z, Satler LF, Pichard AD, Waksman R (2013) Prevalence and effect of myocardial injury after transcatheter aortic valve replacement. Am J Cardiol 111:1337–1343CrossRefPubMed
10.
Zurück zum Zitat Mai J, Wang F, Qiu Q, Tang B, Lin Y, Luo N, Yuan W, Wang X, Chen Q, Wang J, Chen Y (2016) Tachycardia pacing induces myocardial neovascularization and mobilizes circulating endothelial progenitor cells partly via SDF-1 pathway in canines. Heart Vessels 31:230–240CrossRefPubMed Mai J, Wang F, Qiu Q, Tang B, Lin Y, Luo N, Yuan W, Wang X, Chen Q, Wang J, Chen Y (2016) Tachycardia pacing induces myocardial neovascularization and mobilizes circulating endothelial progenitor cells partly via SDF-1 pathway in canines. Heart Vessels 31:230–240CrossRefPubMed
11.
Zurück zum Zitat Lauten A, Ferrari M, Goebel B, Rademacher W, Schumm J, Uth O, Kiehntopf M, Figulla HR, Jung C (2011) Microvascular tissue perfusion is impaired in acutely decompensated heart failure and improves following standard treatment. Eur J Heart Fail 13:711–717CrossRef Lauten A, Ferrari M, Goebel B, Rademacher W, Schumm J, Uth O, Kiehntopf M, Figulla HR, Jung C (2011) Microvascular tissue perfusion is impaired in acutely decompensated heart failure and improves following standard treatment. Eur J Heart Fail 13:711–717CrossRef
12.
Zurück zum Zitat Selle A, Figulla HR, Ferrari M, Rademacher W, Goebel B, Hamadanchi A, Franz M, Schlueter A, Lehmann T, Lauten A (2014) Impact of rapid ventricular pacing during TAVI on microvascular tissue perfusion. Clin Res Cardiol 103:902–911CrossRef Selle A, Figulla HR, Ferrari M, Rademacher W, Goebel B, Hamadanchi A, Franz M, Schlueter A, Lehmann T, Lauten A (2014) Impact of rapid ventricular pacing during TAVI on microvascular tissue perfusion. Clin Res Cardiol 103:902–911CrossRef
13.
Zurück zum Zitat Jung C, Lauten A, Rödiger C, Krizanic F, Figulla HR, Ferrari M (2009) Effect of intra-aortic balloon pump support on microcirculation during high-risk percutaneous intervention. Perfusion 24:417–421CrossRefPubMed Jung C, Lauten A, Rödiger C, Krizanic F, Figulla HR, Ferrari M (2009) Effect of intra-aortic balloon pump support on microcirculation during high-risk percutaneous intervention. Perfusion 24:417–421CrossRefPubMed
14.
Zurück zum Zitat Pipicz M, Varga ZV, Kupai K, Gáspár R, Kocsis GF, Csonka C, Csont T (2015) Rapid ventricular pacing-induced postconditioning attenuates reperfusion injury: effects on peroxynitrite, RISK and SAFE pathways. Br J Pharmacol 172:3472–3483CrossRefPubMedCentral Pipicz M, Varga ZV, Kupai K, Gáspár R, Kocsis GF, Csonka C, Csont T (2015) Rapid ventricular pacing-induced postconditioning attenuates reperfusion injury: effects on peroxynitrite, RISK and SAFE pathways. Br J Pharmacol 172:3472–3483CrossRefPubMedCentral
15.
Zurück zum Zitat Nombela-Franco L, Barbosa Ribeiro H, Allende R, Urena M, Doyle D, Dumont E, Delarochellière R, Rodés-Cabau J (2013) Role of balloon postdilation following trancatheter aortic valve implantation. Minerva Cardioangiol 61:499–512PubMed Nombela-Franco L, Barbosa Ribeiro H, Allende R, Urena M, Doyle D, Dumont E, Delarochellière R, Rodés-Cabau J (2013) Role of balloon postdilation following trancatheter aortic valve implantation. Minerva Cardioangiol 61:499–512PubMed
16.
Zurück zum Zitat Pagnesi M, Jabbour RJ, Latib A, Kawamoto H, Tanaka A, Regazzoli D, Mangieri A, Montalto C, Ancona MB, Giannini F, Chieffo A, Montorfano M, Monaco F, Castiglioni A, Alfieri O, Colombo A (2016) Usefulness of predilation before transcatheter aortic valve implantation. Am J Cardiol 118:107–112CrossRefPubMed Pagnesi M, Jabbour RJ, Latib A, Kawamoto H, Tanaka A, Regazzoli D, Mangieri A, Montalto C, Ancona MB, Giannini F, Chieffo A, Montorfano M, Monaco F, Castiglioni A, Alfieri O, Colombo A (2016) Usefulness of predilation before transcatheter aortic valve implantation. Am J Cardiol 118:107–112CrossRefPubMed
17.
Zurück zum Zitat Grube E, Naber C, Abizaid A, Sousa E, Mendiz O, Lemos P, Kalil Filho R, Mangione J, Buellesfeld L (2011) Feasibility of transcatheter aortic valve implantation without balloon pre-dilation: a pilot study. JACC Cardiovasc Interv 4:751–757CrossRefPubMed Grube E, Naber C, Abizaid A, Sousa E, Mendiz O, Lemos P, Kalil Filho R, Mangione J, Buellesfeld L (2011) Feasibility of transcatheter aortic valve implantation without balloon pre-dilation: a pilot study. JACC Cardiovasc Interv 4:751–757CrossRefPubMed
18.
Zurück zum Zitat Guarracino F, Baldassarri R (2016) The anesthetic management of transcatheter aortic valve implantation. Semin Cardiothorac Vasc Anesth 20:141–146CrossRefPubMed Guarracino F, Baldassarri R (2016) The anesthetic management of transcatheter aortic valve implantation. Semin Cardiothorac Vasc Anesth 20:141–146CrossRefPubMed
19.
Zurück zum Zitat Lhommet P, Espitalier F, Merlini T, Marchand E, Aupart M, Martinez R (2015) Tolerance of rapid right ventricular pacing during thoracic endovascular aortic repair. Ann Vasc Surg 29:578–585CrossRefPubMed Lhommet P, Espitalier F, Merlini T, Marchand E, Aupart M, Martinez R (2015) Tolerance of rapid right ventricular pacing during thoracic endovascular aortic repair. Ann Vasc Surg 29:578–585CrossRefPubMed
Metadaten
Titel
A longer total duration of rapid ventricular pacing does not increase the risk of postprocedural myocardial injury in patients who undergo transcatheter aortic valve implantation
verfasst von
Kenta Okitsu
Takeshi Iritakenishi
Tatsuyuki Imada
Mitsuo Iwasaki
Sho Carl Shibata
Yuji Fujino
Publikationsdatum
20.03.2017
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 9/2017
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-017-0965-8

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