Comparison of permanent pacemaker implantation rate after first and second generation of transcatheter aortic valve implantation–A retrospective cohort study

Sa'ar Minha*, Yuval Yarkoni, Amit Segev, Ariel Finkelstein, Haim Danenberg, Paul Fefer, Katia Orvin, Arie Steinvil, Elad Maor, Roy Beinart, Raphael Rosso, Gregory Golovchiner, Ran Kornowski, Victor Guetta, Israel M. Barbash

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: This study aimed to compare permanent pacemaker implantation (PPMI) rates among patients undergoing Trans-catheter Aortic Valve Implantation (TAVI) with first generation (G1) versus second generation (G2) valves and the impact of PPMI on long-term mortality. Background: PPMI is a known adverse event after TAVI. Recently, two novel iterations of valve designs of both the balloon expandable valves (BEV) and self-expanding valves (SEV) were introduced as a second generation valves. Methods: All patients included in the Israeli multicenter TAVI registry were grouped according to valve type (BEV vs. SEV) and generation (G1 vs. G2). A comparison was made for clinical and outcome indices of patients undergoing TAVI with G1 and G2 in each of the valve systems. Results: A total of 1377 patients were included. The incidence of PPMI did not differ between G1-BEV versus G2-BEV (15.3% vs. 17.4%; p = 0.598) nor between G1-SEV versus G2-SEV (23.4% vs. 20.3%; p = 0.302). Depth of implantation and complete right bundle branch block were independently associated with PPMI post-TAVI in both valve systems. PPMI was not associated with an increased risk for 2-year mortality. Conclusions: The incidence of PPMI remains a relevant adverse event post-TAVI even when the newer generation valves are used. Since the predictors for PPMI are well established, a standardized approach for the management of conduction disorders is much needed.

Original languageEnglish
Pages (from-to)E990-E999
JournalCatheterization and Cardiovascular Interventions
Volume98
Issue number7
DOIs
StatePublished - 1 Dec 2021

Funding

FundersFunder number
Medtronic
Edwards Lifesciences

    Keywords

    • outcomes
    • permanent pacemaker implantation
    • trans-catheter aortic valve replacement

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