Pacemaker dependency after transcatheter aortic valve replacement compared to surgical aortic valve replacement

You Mi Hwang, Jun Kim, Gi Byoung Nam, Kee Joon Choi, Duk Woo Park, Do Yoon Kang, Seung Jung Park, Seo Young Park

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Transcatheter aortic valve replacement (TAVR) is a standard treatment indicated for severe aortic stenosis in high-risk patients. The objective of this study was to evaluate the incidence of pacemaker dependency after permanent pacemaker implantation (PPI) following TAVR or surgical aortic valve replacement (SAVR) and the risk of mortality at a tertiary center in Korea.In this retrospective study conducted at a single tertiary center, clinical outcomes related to pacemaker dependency were evaluated for patients implanted with pacemakers after TAVR from January 2012 to November 2018 and post-SAVR from January 2005 to May 2015. Investigators reviewed patients' electrocardiograms and baseline rhythms as well as conduction abnormalities. Pacemaker dependency was defined as a ventricular pacing rate > 90% with an intrinsic rate of <40bpm during interrogation.Of 511 patients who underwent TAVR for severe AS, 37(7.3%) underwent PPI after a median duration of 6 (3-7) days, whereas pacemakers were implanted after a median interval of 13 (8-28) days post-SAVR in 10 of 663 patients (P<.001). Pacemaker dependency was observed in 36 (97.3%) patients during 7days immediately post-TAVR and in 25 (64.9%) patients between 8 and 180days post-TAVR. Pacemaker dependency occurred after 180days in 17 (50%) patients with TAVR and in 4 (44.4%) patients with SAVR. Twelve (41.4%) patients were pacemaker-dependent after 365days post-TAVR.Pacemaker dependency did not differ at 6months after TAVR vs SAVR. In patients undergoing post-TAVR PPI, 58.6% were not pacemaker-dependent at 1 year after the TAVR procedure.

Original languageEnglish
Pages (from-to)E26123
JournalMedicine (United States)
Volume100
Issue number22
DOIs
StatePublished - 4 Jun 2021

Bibliographical note

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • aortic valve stenosis
  • artificial
  • heart conduction system
  • pacemaker
  • transcatheter aortic valve replacement

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