1. Incidence and Predictors of Permanent Pacemaker Implantation in Patients Who Underwent Transcatheter Aortic Valve Replacement: Observation of a Chinese Population
- Author
-
Qifeng Zhu, Han Chen, Xianbao Liu, Jubo Jiang, Fang Du, and Jian-an Wang
- Subjects
Male ,Aortic valve ,China ,Pacemaker, Artificial ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Transcatheter Aortic Valve Replacement ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Bicuspid aortic valve ,Valve replacement ,Risk Factors ,Internal medicine ,0502 economics and business ,Humans ,Medicine ,Pharmacology (medical) ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Incidence ,Incidence (epidemiology) ,05 social sciences ,Cardiac Pacing, Artificial ,Arrhythmias, Cardiac ,Aortic Valve Stenosis ,Right bundle branch block ,medicine.disease ,Logistic Models ,Treatment Outcome ,medicine.anatomical_structure ,Heart Valve Prosthesis ,Multivariate Analysis ,Cardiology ,Population study ,Female ,050211 marketing ,Permanent pacemaker ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
Aims: Permanent pacemaker (PPM) implantation is one of the most common complications after transcatheter aortic valve replacement (TAVR). We studied the incidence of PPM implantation and identified the predictors in patients who underwent TAVR in a Chinese population. Methods and Results: A total of 256 patients who underwent TAVR with self-expandable valves were included. The incidence of PPM implantation in our study population was 14.8%. In patients who received PPM implantation, the proportion of bicuspid aortic valve (BAV) patients was much lower compared to tricuspid aortic valve (TAV) patients (18.4 vs. 81.6%, p < 0.05). Patients with BAV were associated with a significantly lower PPM implantation rate and shallower implantation depth compared to patients with TAV (6.4 vs. 21.7% and 4.2 ± 4.4 vs. 6.2 ± 5.0 mm, respectively, p < 0.05 for both). In the multivariable logistic regression analysis, prior right bundle branch block (RBBB; OR 8.3, 95% CI 2.2–32.1, p < 0.05), implantation depth (OR 1.3, 95% CI 1.1–1.5, p = 0.01), and TAV (OR 4.7, 95% CI 1.5–14.4, p < 0.05) were independent predictors of PPM implantation after TAVR. There was no difference in 30-day and 1-year all-cause mortality between the 2 groups. Conclusions: The incidence of PPM implantation in patients with self-expandable valves after TAVR was 14.8% in our cohort study. Independent predictors of PPM implantation included prior RBBB, TAV, and implantation depth at the noncoronary sinus side. TAVR in BAV with a supra-annular structure-based sizing strategy might decrease the risk of PPM implantation.
- Published
- 2019