Tichelbaecker, Tobias and Bergau, Leonard and Puls, Miriam and Friede, Tim and Muetze, Tobias and Maier, Lars Siegfried and Frey, Norbert and Hasenfuss, Gerd and Zabel, Markus and Jacobshagen, Claudius and Sossalla, Samuel (2018) Insights into permanent pacemaker implantation following TAVR in a real-world cohort. PLOS ONE, 13 (10): e0204503. ISSN 1932-6203,
Full text not available from this repository. (Request a copy)Abstract
Background Permanent pacemaker implantation (PPI) following TAVR is a frequent post interventional complication and its management remains controversial. Objective We sought to elucidate the electrophysiological, procedural, and clinical baseline parameters that are associated with and perhaps predict the need for PPI after TAVR in a heterogeneous-valve-type real-world cohort. Methods Overall, 494 patients receiving TAVR at our center from April 2009 to August 2015 were screened. ECG analyses and clinical parameters were collected prospectively. Results Overall, 401 patients in this all-comers real-world TAVR cohort with a PPI rate of 16% were included. The mean age was 82 years, and the mean duration to PPI was 5.5 days. A large proportion of Edwards SAPIEN valves (81%), DirectFlow, Core Valve, and Portico were implanted. The main indications for PPI were atrioventricular (AV) block III, AV-block Mobitz type II, bradycardic atrial fibrillation and persistent sinus bradycardia. Between groups with and without PPI, significant differences were noted in the prevalence of post TAVR balloon dilatation, resting heart rate, QRS interval, PR interval with a cut-off of >178 ms, left anterior fascicular block and RBBB in univariate analyses. In the subsequent multiple regression analysis, post TAVR balloon dilatation and a PR interval with a cut-off of >178 ms were significant predictors of PPI. Conclusion This real-world cohort differs from others in its size and heterogeneous valve selection, and indicates for the first time that patients with post balloon dilatation or prolonged PR interval are at a higher risk for pacemaker dependency after TAVR.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | AORTIC-VALVE-REPLACEMENT; INTERMEDIATE-RISK PATIENTS; CONDUCTION ABNORMALITIES; TRANSCATHETER; PREDICTORS; REGURGITATION; REGISTRY; COMPLICATIONS; OUTCOMES; DEVICE; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Dec 2019 08:30 |
| Last Modified: | 05 Dec 2019 08:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13685 |
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