RT Journal Article
T1 Long-Term Outcomes in Patients With New Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement.
A1 Chamandi, Chekrallah
A1 Barbanti, Marco
A1 Munoz-Garcia, Antonio
A1 Latib, Azeem
A1 Nombela-Franco, Luis
A1 Gutiérrez-Ibanez, Enrique
A1 Veiga-Fernandez, Gabriela
A1 Cheema, Asim N
A1 Cruz-Gonzalez, Ignacio
A1 Serra, Vicenç
A1 Tamburino, Corrado
A1 Mangieri, Antonio
A1 Colombo, Antonio
A1 Jiménez-Quevedo, Pilar
A1 Elizaga, Jaime
A1 Laughlin, Gerard
A1 Lee, Dae-Hyun
A1 Garcia Del Blanco, Bruno
A1 Rodriguez-Gabella, Tania
A1 Marsal, Josep-Ramon
A1 Côté, Mélanie
A1 Philippon, François
A1 Rodés-Cabau, Josep
K1 aortic stenosis
K1 left ventricular ejection fraction
K1 pacemaker
K1 transcatheter aortic valve replacement
AB This study sought to evaluate the long-term clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). Conduction disturbances leading to PPI are common following TAVR. However, no data exist regarding the impact of PPI on long-term outcomes post-TAVR. This was a multicenter study including a total of 1,629 patients without prior PPI undergoing TAVR (balloon- and self-expandable valves in 45% and 55% of patients, respectively). Follow-up clinical, echocardiographic, and pacing data were obtained at a median of 4 years (interquartile range: 3 to 5 years) post-TAVR. PPI was required in 322 (19.8%) patients within 30 days post-TAVR (26.9% and 10.9% in patients receiving self- and balloon-expandable CoreValve and Edwards systems, respectively). Up to 86% of patients with PPI exhibited pacing >1% of the time during follow-up (>40% pacing in 51% of patients). There were no differences between patients with and without PPI in total mortality (48.5% vs. 42.9%; adjusted hazard ratio [HR]: 1.15; 95% confidence interval [CI]: 0.95 to 1.39; p = 0.15) and cardiovascular mortality (14.9% vs. 15.5%, adjusted HR: 0.93; 95% CI: 0.66 to 1.30; p = 0.66) at follow-up. However, patients with PPI had higher rates of rehospitalization due to heart failure (22.4% vs. 16.1%; adjusted HR: 1.42; 95% CI: 1.06 to 1.89; p = 0.019), and the combined endpoint of mortality or heart failure rehospitalization (59.6% vs. 51.9%; adjusted HR: 1.25; 95% CI: 1.05 to 1.48; p = 0.011). PPI was associated with lesser improvement in LVEF over time (p = 0.051 for changes in LVEF between groups), particularly in patients with reduced LVEF before TAVR (p = 0.005 for changes in LVEF between groups). The need for PPI post-TAVR was frequent and associated with an increased risk of heart failure rehospitalization and lack of LVEF improvement, but not mortality, after a median follow-up of 4 years. Most patients with new PPI post-TAVR exhibited some degree of pacing activity at follow-up.
YR 2018
FD 2018
LK http://hdl.handle.net/10668/12095
UL http://hdl.handle.net/10668/12095
LA en
DS RISalud
RD Apr 8, 2025