Article ; Online: Electrocardiographic and clinical predictors for permanent pacemaker requirement after transcatheter aortic valve implantation: a 10-year single center experience.
The Journal of cardiovascular surgery
2020 Volume 62, Issue 2, Page(s) 169–174
Abstract: Background: The aim of this study is to identify clinical, electrocardiographic (ECG) and procedural predictors for permanent pacemaker (PPM) requirement after transaortic valve implantation (TAVI).: Methods: All consecutive patients with severe ... ...
| Abstract | Background: The aim of this study is to identify clinical, electrocardiographic (ECG) and procedural predictors for permanent pacemaker (PPM) requirement after transaortic valve implantation (TAVI). Methods: All consecutive patients with severe symptomatic aortic stenosis (SSAS) undergoing TAVI at our single center were included in the study and prospectively followed. All patients had standard 12-leads ECGs recordings before and after TAVI and continuous ECG monitoring during hospital stay. Primary endpoint was to identify electrocardiographic predictors of PPM implantation after TAVI; secondary endpoint was to ascertain other clinical or procedure-related predictive factors of PPM need. PPM implantation was further arbitrarily divided into early and late one (beyond the 3 Results: Among the 431 patients undergoing TAVI between 2008 and 2018, 77 (18%) needed PPM implantation; 47 (11%) had an early procedure, and 30 (7%) a late implant. Preoperative right bundle branch block (RBBB) implies more than five-fold increase of the risk of PPM implantation (OR 5.19, CI 1.99-13.56, P=0.001), whereas the use of a self-expandable prosthesis is associated with an almost three-fold increase of the risk (OR 2.60, CI 1.28-5.28, P=0.008). In the late PPM implantation subgroup, only the history of syncope retains a significant association with such an increased risk (OR 2.71, CI 1.09-6.75, P=0.032). Conclusions: The need of a PPM in the individual TAVI patient is hardly predictable. However, the finding of pre-existing RBBB, the use of self-expandable prosthesis and history of syncope can individuate patients at increased risk. |
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| MeSH term(s) | Aged, 80 and over ; Aortic Valve Stenosis/surgery ; Bundle-Branch Block/surgery ; Electrocardiography ; Female ; Humans ; Male ; Pacemaker, Artificial ; Postoperative Complications/surgery ; Risk Factors ; Transcatheter Aortic Valve Replacement | |||||
| Language | English | |||||
| Publishing date | 2020-09-04 | |||||
| Publishing country | Italy | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 80143-4 | |||||
| ISSN | 1827-191X ; 0021-9509 | |||||
| ISSN (online) | 1827-191X | |||||
| ISSN | 0021-9509 | |||||
| DOI | 10.23736/S0021-9509.20.11342-9 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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