Implantation depth of balloon‐expandable transcatheter heart valves and risks for permanent pacemaker implantation and midterm adverse events

Background Permanent pacemaker implantation (PPI) remains a relevant complication after transcatheter aortic valve implantation (TAVI) and its impact on outcome remains controversial. Aims This study aimed to analyze the effects of implantation depth on PPI at 30 days and assess its impact on outcom...

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Published in:Catheterization and cardiovascular interventions 2023-12, Vol.102 (7), p.1301-1310
Main Authors: Pellegrini, Costanza, Freißmuth, Markus, Rheude, Tobias, Graas, David, Mayr, N. Patrick, Syryca, Finn, Alvarez‐Covarrubias, Hector A., Fetcu, Andrei, Hübner, Judith, Lennerz, Carsten, Schunkert, Heribert, Kastrati, Adnan, Xhepa, Erion, Joner, Michael
Format: Article
Language:English
Subjects:
Aortic valve
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - surgery
Atrial Fibrillation - diagnosis
Atrial Fibrillation - etiology
Atrial Fibrillation - therapy
Balloon treatment
Cardiac arrhythmia
Diabetes
Diabetes Mellitus
Fibrillation
Heart Valve Prosthesis - adverse effects
Humans
implantation depth
Mortality
Multivariate analysis
pacemaker implantation
Pacemaker, Artificial
Pacemakers
Prostheses
Regression analysis
Risk Factors
TAVI
Transcatheter Aortic Valve Replacement
Treatment Outcome
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Summary:Background Permanent pacemaker implantation (PPI) remains a relevant complication after transcatheter aortic valve implantation (TAVI) and its impact on outcome remains controversial. Aims This study aimed to analyze the effects of implantation depth on PPI at 30 days and assess its impact on outcome with the balloon‐expandable Sapien 3 (S3) prosthesis. Methods Between 2014 and 2018, 849 patients without previous pacemaker undergoing transfemoral TAVI with the S3 were included. Prosthesis implantation depth was measured and divided into Quintiles. An ordinal logistic regression was used to assess its association with PPI, while a multivariate logistic regression was performed to identify predictors of PPI. Survival analyses were performed with the Kaplan−Meier method and a multivariable Cox regression was performed to ascertain the impact of PPI on mortality. Results Overall, incidence of PPI at 30 days was 9.7%. Implantation depth decreased consistently from a median of 6.7 mm [5.55−8.00] in 2014 to 2.7 mm [2.30−3.50] in 2018 (p 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30870