Incidence and Predictors of Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement

• DOI: 10.1111/pace.12653
• Publication Date: 2015-05-05T08:07:50Z
• Authors: ABHISHEK MAAN; MARWAN M. REFAAT; EDWIN KEVIN HEIST; JONATHAN PASSERI; IGNACIO INGLESSIS; LEON PTASZEK; GUS VLAHAKES; JEREMY N. RUSKIN; IGOR PALACIOS; THORALF SUNDT; MOUSSA MANSOUR
• Keywords: Valve replacement; Permanent pacemaker; Ventricular outflow tract

Background Transcatheter aortic valve replacement (TAVR) has emerged as an alternative treatment for patients with symptomatic stenosis who are at high risk surgical replacement. The development of conduction abnormalities is a major complication in the postprocedural period TAVR. Objectives objective this study was to investigate and requirement permanent pacemaker (PPM) implantation undergoing Methods Data from 137 consecutive underwent TAVR (Edwards SAPIEN valve, Edwards Lifesciences, Irvine, CA, USA) between June 2008 October 2012 were reviewed. Patients prior history PPM (n = 27) excluded. role various predictors after TAVR, including index (calculated [valve size/left ventricular outflow tract diameter] × 100) investigated. Results A total 31/110 (28.2%) required median time 5 days procedure. complete heart block most common indication (16/31; 51.6%). On multivariate analysis, presence preexisting right bundle branch (RBBB) found be strong predictor (adjusted odds ratio: 4.87; 95% confidence interval: 1.29–18.46, P 0.020). Using receiver operated curve cut‐off value 128 sensitivity 73% specificity 61% (c statistic 0.68). Conclusions This identified RBBB important factors larger implanted size relative left diameter leads greater compression intrinsic system, increasing need placement.