Importance of Monitoring Cardiac Arrhythmias Using 14-Day Patch Electrocardiography in Super Older Patients Who Underwent Transcatheter Aortic Valve Replacement.

Transcatheter aortic valve replacement (TAVR) is one of the best treatment options for severe aortic stenosis (AS) in patients with a high or very high surgical risk. 1 Leon MB Smith CR Mack M Miller DC Moses JW Svensson LG Tuzcu EM Webb JG Fontana GP Makkar RR Brown DL Block PC Guyton RA Pichard AD Bavaria JE Herrmann HC Douglas PS Petersen JL Akin JJ Anderson WN Wang D Pocock S PARTNER Trial InvestigatorsTranscatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363: 1597-1607 Crossref PubMed Scopus (5788) Google Scholar , 2 Smith CR Leon MB Mack MJ Miller DC Moses JW Svensson LG Tuzcu EM Webb JG Fontana GP Makkar RR Williams M Dewey T Kapadia S Babaliaros V Thourani VH Corso P Pichard AD Bavaria JE Herrmann HC Akin JJ Anderson WN Wang D Pocock SJ PARTNER Trial InvestigatorsTranscatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011; 364: 2187-2198 Crossref PubMed Scopus (5106) Google Scholar , 3 Popma JJ Adams DH Reardon MJ Yakubov SJ Kleiman NS Heimansohn D Hermiller Jr, J Hughes GC Harrison JK Coselli J Diez J Kafi A Schreiber T Gleason TG Conte J Buchbinder M Deeb GM Carabello B Serruys PW Chenoweth S Oh JK CoreValve United States Clinical InvestigatorsTranscatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery. J Am Coll Cardiol. 2014; 63: 1972-1981 Crossref PubMed Scopus (843) Google Scholar A variety of arrhythmias are known to occur after TAVR surgery. Recent reports have indicated that the perioperative complication rate of TAVR has decreased markedly, and that most patients are discharged within 2 days after TAVR. 4 Reinöhl J Kaier K Reinecke H Schmoor C Frankenstein L Vach W Cribier A Beyersdorf F Bode C Zehender M Effect of availability of transcatheter aortic-valve replacement on clinical practice. N Engl J Med. 2015; 373: 2438-2447 Crossref PubMed Scopus (181) Google Scholar ,5 Carroll JD Mack MJ Vemulapalli S Herrmann HC Gleason TG Hanzel G Deeb GM Thourani VH Cohen DJ Desai N Kirtane AJ Fitzgerald S Michaels J Krohn C Masoudi FA Brindis RG Bavaria JE STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol. 2020; 76: 2492-2516 Crossref PubMed Scopus (445) Google Scholar Given the trend toward significantly shorter hospital stays after TAVR, some of early postoperative arrhythmias might be missed. A patch electrocardiograph (ECG) that records ECG continuously for 7 to 14 days has been launched and is useful in the management of arrhythmias in various settings (e.g., after cardiovascular surgery, after atrial fibrillation [AF] ablation etc). 6 Ha ACT Verma S Mazer CD Quan A Yanagawa B Latter DA Yau TM Jacques F Brown CD Singal RK Yamashita MH Saha T Teoh KH Lam B-K Deyell MW Wilson M Hibino M Cheung CC Kosmopoulos A Garg V Brodutch S Teoh H Zuo F Thorpe KE Jüni P Bhatt DL Verma A SEARCH AF CardioLink-1 InvestigatorsEffect of continuous electrocardiogram monitoring on detection of undiagnosed atrial fibrillation after hospitalization for cardiac surgery: a randomized clinical trial. JAMA Netw Open. 2021; 4e2121867 Crossref Scopus (20) Google Scholar ,7 Ikeda T Current use and future needs of noninvasive ambulatory electrocardiogram monitoring. Intern Med. 2021; 60: 9-14 Crossref PubMed Scopus (10) Google Scholar We therefore evaluated the incidence and time course of arrhythmic events at early phase (within 2 week) after TAVR using continuous 14-day patch ECG monitoring in super older patients.