Influence of permanent pacemaker implantation after transcatheter aortic valve implantation with new-generation devices

Objective Permanent pacemaker implantation (PPMI) after transcatheter aortic valve implantation (TAVI) is the most common complication after the procedure. PPMI rates remain high with the new-generation TAVI devices despite improved outcomes concerning paravalvular aortic regurgitation and vascular...

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Bibliographic Details
Published in:Netherlands heart journal 2018-12, Vol.26 (12), p.620-627
Main Authors: Gonska, B., Keßler, M., Wöhrle, J., Rottbauer, W., Seeger, J.
Format: Article
Language:English
Subjects:
Aortic stenosis
Body mass index
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Diabetes
Ejection fraction
Heart attacks
Heart failure
Medical Education
Medicine
Medicine & Public Health
Mortality
Original
Original Article
Pacemakers
Patients
Software
Statistical analysis
Surgeons
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Summary:Objective Permanent pacemaker implantation (PPMI) after transcatheter aortic valve implantation (TAVI) is the most common complication after the procedure. PPMI rates remain high with the new-generation TAVI devices despite improved outcomes concerning paravalvular aortic regurgitation and vascular access complications. However, the impact of PPMI on mortality and clinical outcome is still a matter of debate, and data with new-generation devices on this matter are scarce. Therefore, we sought to analyse the influence of PPMI in patients treated with the new-generation devices on one-year outcome. Methods We enrolled 612 consecutive patients without prior pacemaker undergoing transfemoral TAVI with the new-generation devices. Patients with or without PPMI were compared with respect to clinical outcome within one year. Results PPMI was performed in 168 patients (24.4% of the overall study population). There was no significant difference in one-year outcome concerning all-cause mortality (PPMI vs. no-PPMI: 12.2% vs. 12.5%, p  = 0.94), rate of major adverse events including cardiac, cerebral or valve-related events and bleeding complications (22.1% vs. 24.5%, p  = 0.55) or need for rehospitalisation due to cardiac symptoms (16.1% vs. 18.1%, p  = 0.63). In patients with reduced ejection fraction (
ISSN:1568-5888
1876-6250
DOI:10.1007/s12471-018-1194-1