Long-term percentage of ventricular pacing in patients requiring pacemaker implantation after transcatheter aortic valve replacement: A multicenter 10-year experience

Enrico Baldi, Miriam Compagnone, Daniele Errigo, Marco Ferlini, Matteo Ziacchi, Davide Castagno, Alessandro Minguzzi, Andrea Demarchi, Simone Savastano, Francesco Bruno, Pier Giorgio Golzio, Tullio Palmerini, Francesco Saia, Ciro Di Giacomo, Silvia Mauri, Mauro Biffi, Gaetano Maria De Ferrari, Roberto Rordorf

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Recent studies suggest that atrioventricular (AV) conduction may recover after pacemaker (PM) implantation following transcatheter aortic valve replacement (TAVR), but little is known about long-term follow-up of such patients. Objective: The purpose of this study was to evaluate the long-term percentage of right ventricular pacing in patients who underwent TAVR and required PM implantation stratified based on the indication for permanent pacing. Methods: Retrospective analysis of all consecutive patients who underwent TAVR from February 2008 to August 2019 at 3 centers was performed. Patients already implanted with a PM/implantable cardioverter–defibrillator (ICD) before TAVR, implanted with a cardiac resynchronization therapy device, or implanted >30 days after TAVR were excluded. Eligible patients were divided into 2 groups based on the presence (persistent atrioventricular block [AVB] group) or absence (nonpersistent AVB group) of persistent third-degree AVB after TAVR. Results: A total of 1594 patients underwent TAVR. Two hundred four patients were implanted with a PM or ICD after TAVR and 32 met exclusion criteria, so 172 patients were eligible (median time TAVR–PM implant 4 days) for a total of 352 follow-up visits analyzed. A significant difference in the percentage of ventricular pacing was observed at follow-up performed 7–90 days after implantation (98% persistent AVB group vs 8% nonpersistent AVB group; P <.001). This difference remained significant at follow-up performed 91–270 days (95% vs 3.5%; P <.001), 271–540 days (95.5% vs 3%; P = .006), and 541–900 days (97.4% vs 2.2%; P <.001) after implantation. Conclusion: Patients requiring PM implantation due to persistent third-degree AVB after TAVR were less likely to show AV conduction recovery, whereas patients implanted for other indications showed a low percentage of pacing during follow-up.

Original languageEnglish
JournalHeart Rhythm
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Atrioventricular conduction
  • Pacemaker
  • Pacing
  • Recovery
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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