Short-term effect of transcatheter aortic valve implantation on QT dispersion

Objective & Hypothesis:Background/aim: Electrophysiological changes are observed following mechanical stretches due to pressure overload in patients with severe aortic stenosis (AS).

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Key Findings & Data:Materials and methods: The study population included 100 consecutive patients with severe AS that underwent TAVI.

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Conclusion & Impact:Following TAVI, a decrease in QTd might reduce the risk of ventricular arrhythmia in patients with severe AS.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Transcatheter aortic valve implantation · QT dispersion · aortic stenosis

Abstract

Background/aim: Electrophysiological changes are observed following mechanical stretches due to pressure overload in patients with severe aortic stenosis (AS). The electrical instability occurs after depolarization and dispersion of repolarization. The aim of this study was to evaluate changes in ventricular repolarization following transcatheter aortic valve implantation (TAVI). Materials and methods: The study population included 100 consecutive patients with severe AS that underwent TAVI. Electrocardiography (ECG) was performed at baseline, immediately after TAVI, and 1 week after TAVI. Results: The mean age of the patients was 78.2 ± 7.2 years. Thirty-four (34%) of the patients were male and 66 (66%) were female. Compared to the baseline, mean QT dispersion (QTd) immediately after TAVI and 1 week after TAVI decreased significantly (82.8 ± 26.5, 75.6 ± 25.2, and 65.8 ± 28.3, respectively, P < 0.001). Likewise, compared to the baseline, mean corrected QTd (QTcd) immediately after TAVI and 1 week after TAVI decreased significantly (84.7 ± 25.2, 76.7 ± 30.8, and 69.1 ± 31.4, respectively, P < 0.001). Conclusion: QTd is indicative of heterogeneity of ventricular refractoriness and is prolonged in patients with AS. Following TAVI, a decrease in QTd might reduce the risk of ventricular arrhythmia in patients with severe AS.

Özet

Background/aim: Electrophysiological changes are observed following mechanical stretches due to pressure overload in patients with severe aortic stenosis (AS). The electrical instability occurs after depolarization and dispersion of repolarization. The aim of this study was to evaluate changes in ventricular repolarization following transcatheter aortic valve implantation (TAVI). Materials and methods: The study population included 100 consecutive patients with severe AS that underwent TAVI. Electrocardiography (ECG) was performed at baseline, immediately after TAVI, and 1 week after TAVI. Results: The mean age of the patients was 78.2 ± 7.2 years. Thirty-four (34%) of the patients were male and 66 (66%) were female. Compared to the baseline, mean QT dispersion (QTd) immediately after TAVI and 1 week after TAVI decreased significantly (82.8 ± 26.5, 75.6 ± 25.2, and 65.8 ± 28.3, respectively, P < 0.001). Likewise, compared to the baseline, mean corrected QTd (QTcd) immediately after TAVI and 1 week after TAVI decreased significantly (84.7 ± 25.2, 76.7 ± 30.8, and 69.1 ± 31.4, respectively, P < 0.001). Conclusion: QTd is indicative of heterogeneity of ventricular refractoriness and is prolonged in patients with AS. Following TAVI, a decrease in QTd might reduce the risk of ventricular arrhythmia in patients with severe AS.

Keywords

Transcatheter aortic valve implantation QT dispersion aortic stenosis

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Cite This Article

KASAPKARA, H. A., AYHAN, H., DURMAZ, T., KELEŞ, T., SARI, C., BAŞTUĞ, S., KÖSEOĞLU, C., KARADUMAN, B. D., AKÇAY, M., BAYRAM, N. A., BİLEN, E., BOZKURT, E. (2015). Short-term effect of transcatheter aortic valve implantation on QT dispersion. Turkish Journal of Medical Sciences, Cilt: 45 - Sayı: 3, 615–618. https://ajindex.com/articles/113956

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References (13)

Bonow RO, Carabello BA, Kanu C, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. Circulation 2006; 114: 84–231
Piorecka-Makula A, Werner B. Prolonged QT dispersion in children with congenital valvular aortic stenosis. Med Sci Monit 2009; 15: 534–538
Kremer R. Arrhythmias in the natural history of aortic stenosis. Acta Cardiol 1992; 47: 135–140. 4. van de Loo A, Arendts W, Hohnloser SH. Variability of QT dispersion measurements in the surface electrocardiogram in patients with acute myocardial infarction and in normal subjects. Am J Cardiol 1994; 74: 1113–1118
Üçkuyu A, Çiftçi FC, Çiftçi Ö, Özçimen EE, Toprak E, Turhan E. Effect of ovulation induction on QT dispersion in electrocardiography. Turk J Med Sci 2012; 42: 491–496
Okin PM, Devereux RB, Howard BV, Fabsitz RR, Lee ET, Welty TK. Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: The Strong Heart Study. Circulation 2000; 101: 61–66
Beaubien ER, Pylypchuk GB, Akhtar J, Biem HJ. Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality. Am J Kidney Dis 2002; 39: 834–842
Darbar D, Cherry CJ, Kerins DM. QT dispersion is reduced after valve replacement in patients with aortic stenosis. Heart 1999; 82: 15–18
Cohle SD, Graham MA, Dowling G, Pounder DJ. Sudden death and left ventricular outflow disease. Pathol Annu 1988; 23: 97– 124
Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Barwolf C, Levang OW, Tornos P, Vanoverschelde JL, Vermeer F, Boersma E et al. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003; 24: 1231–1243
Martínez-Useros C, Tornos P, Montoyo J, Permanyer Miralda G, Alijarde M, García del Castillo H, Moreno V, Soler-Soler J. Ventricular arrhythmias in aortic valve disease: a further marker of impaired left ventricular function. Int J Cardiol 1992; 34: 49–56
Messerli FH, Soria F. Ventricular dysrhythmias, left ventricular hypertrophy and sudden death. Cardiovasc Drugs Ther 1994; 8: 557–563
Bikkina M, Larson MG, Levy D. Asymptomatic ventricular arrhythmias and mortality risk in subjects with left ventricular hypertrophy. J Am Coll Cardiol 1993; 22: 1111–1116
Fielitz J, Hein S, Mitro