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    Association between fragmented QRS and postprocedural rhythm disturbances in patients who underwent transcatheter aortic valve implantation
    (Assoc Medica Brasileira, 2021) Duran, Mustafa; Ziyrek, Murat; Alsancak, Yakup; Ayhan, Huseyin
    INTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation' sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p<0.05) and the incidence of atrioventricular blocks requiring permanent pacing (21.1 versus 0%, p<0.05) following transcatheter aortic valve implantation in patients whose preprocedural electrocardiogram recordings revealed fragmented QRS compared to those without fragmented QRS. Based our collected data, the presence of QRS fragmentation in anterior derivations was the only independent factor associated with postprocedural rhythm disturbances (B-value 0.217; OR 0.805; 95%CI 0.136-4.78; p=0.004). CONCLUSION: Our data showed an increased risk for the development of new-onset left bundle branch block and atrioventricular blocks following transcatheter aortic valve implantation in patients whose baseline electrocardiogram recordings demonstrated QRS fragmentation.
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    Association between fragmented QRS and postprocedural rhythm disturbances in patients who underwent transcatheter aortic valve implantation
    (Assoc Medica Brasileira, 2021) Duran, Mustafa; Ziyrek, Murat; Alsancak, Yakup; Ayhan, Huseyin
    INTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation' sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p<0.05) and the incidence of atrioventricular blocks requiring permanent pacing (21.1 versus 0%, p<0.05) following transcatheter aortic valve implantation in patients whose preprocedural electrocardiogram recordings revealed fragmented QRS compared to those without fragmented QRS. Based our collected data, the presence of QRS fragmentation in anterior derivations was the only independent factor associated with postprocedural rhythm disturbances (B-value 0.217; OR 0.805; 95%CI 0.136-4.78; p=0.004). CONCLUSION: Our data showed an increased risk for the development of new-onset left bundle branch block and atrioventricular blocks following transcatheter aortic valve implantation in patients whose baseline electrocardiogram recordings demonstrated QRS fragmentation.
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    Can the Ratio of Calcium to Albumin Predict the Severity of Aortic Stenosis?
    (Aves, 2019) Alsancak, Yakup; Sivri, Serkan; Bastug, Serdal; Ayhan, Huseyin; Bozkurt, Engin
    Objective: Aortic sclerosis is observed in 25% of the elderly population, and 2.5% of these patients have severe aortic stenosis (AS). Numerous studies have reported a relationship between the serum calcium or albumin levels and AS. The present study investigated the relationship between the calcium toalbumin ratio (CAR) and AS. Methods: Our study included 185 patients and 108 subjects as the control group. A routine transthoracic echocardiographic evaluation and laboratory examinations were performed inall participants. The corrected serum calcium levels were calculated using the most commonly used formula: corrected calcium=measured total calcium (mg/dL) + 0.8 (4.0-serum albumin [g/dL]). Results: The serum C-reactive protein CRP, calcium, and corrected calcium levels were significantly different between the study groups (p<0.05), and the albumin levels were significantly decreased parallel with the AS severity (p<0.001). Also, we detected a negative correlation between the albumin and corrected calcium levels and the EuroSCORE. CAR and corrected calcium to albumin ratio (cCAR) were significantly higher in the AS group, as expected (p<0.01). In the logistic regression analysis, albumin, CRP, low-density lipoprotein LDL, theCAR, and cCAR levels were found to be significantly and independently associated with the presence of AS (p<0.05). Moreover, in a regression analysis in the subgroup of AS only, albumin, the cCAR, and CAR were independently associated with the presence of very severe AS. Conclusion: Our study showed an important relationship between the CAR and AS. Therefore, in clinical practice, this simple, inexpensive, and practical method may predict the severity of AS.