Valvular & structural heart disease
Preprocedural computed tomography angiography-based conduction system simulation for optimized patient-specific transcatheter aortic valve implantation deployment
Authors' conclusion
CTA-based conduction system simulation may offer a patient-specific, conduction-axis-guided TAVI deployment strategy, minimizing the need for PPI.
Study context
- Population
- Patients who received transcatheter aortic valve implantation (TAVI), with computed tomography angiography (CTA)-based conduction system simulation (CARA Metis) applied retrospectively
- Participants
- 228 patients
- Exposure
- Patient-specific conduction system protocol vs implantation 1-2 mm, 2-3 mm and 3-4 mm below the aortic annulus
- Above conduction systemn = 25
- Outcome
- Postprocedural PPI
Methodological detailspost hoc classification
- Post hoc classification
Main finding
As reported in the abstract
PPI
Odds ratio (95% CI)
Implantation below point B (per 1 mm)His bundle point B
1.25(1.14–1.39)
Implantation below midpoint BC (per 1 mm)His bundle midpoint BC
1.27(1.14–1.42)
Implantation below point C (per 1 mm)left bundle branch origin
1.24(1.12–1.38)
Per 1 mm, as printed
Observational data: associations, not effects.
Further findings
Distance of conduction landmarks to aortic annulus
mm
- Point B (His bundle), mean (SD)
- 5.3 (2.3)
- Midpoint BC, mean (SD)
- 3.9 (2.1)
- Point C (left bundle branch origin), mean (SD)
- 2.5 (2.2)
Original publication
Preprocedural computed tomography angiography-based conduction system simulation for optimized patient-specific transcatheter aortic valve implantation deployment. Heart Rhythm. Published 17 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →