Incidence, predictors and clinical impact of permanent pacemaker insertion in women following transcatheter aortic valve implantation: Insights from a prospective multinational registry

Nicolas, Johny; Guedeney, Paul; Claessen, Bimmer E.; Mehilli, Julinda; Petronio, Anna Sonia; Sartori, Samantha; Lefèvre, Thierry; Presbitero, Patrizia; Capranzano, Piera; Iadanza, Alessandro; Cao, Davide; Chiarito, Mauro; Goel, Ridhima; Roumeliotis, Anastasios; Chandiramani, Rishi; Sardella, Gennaro; Mieghem, Nicolas Van; Sorrentino, Sabato; Meliga, Emanuele; Tchétché, Didier; Dumonteil, Nicolas; Fraccaro, Chiara; Trabattoni, Daniela; Mikhail, Ghada; Ferrer-Gracia, Maria-Cruz; Naber, Christoph; Kievit, Peter C.; Baber, Usman; Sharma, Samin K.; Morice, Marie‐Claude; Dangas, George; Chandrasekhar, Jaya; Chieffo, Alaide

doi:10.1002/ccd.29807

Cited by 6 publications

(4 citation statements)

References 47 publications

(105 reference statements)

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“…Ferreira T et al ( 25 ) demonstrated that increased H-V interval, which showed in post-TAVR electrophysiological study, was the best predictor of PPM implantation undergoing TAVR. A previous study by Johny Nicolas et al ( 26 ) showed that RBBB before TAVR was the only predictor.…”

Section: Discussionmentioning

confidence: 94%

“…All studies were cohort studies. RBBB prior to TAVR was considered to be a predictor in most of the selected studies ( 9 , 12 , 22 , 24 , 26 ) in Table 4 . However, the association of new-onset LBBB with PPM implantation after TAVR has not been fully characterized.…”

Section: Discussionmentioning

confidence: 99%

“…New-onset AF 7 ( The predictors of PPM implantation in patients receiving TAVR have been examined in seven studies (9,12,(22)(23)(24)(25)(26). All studies were cohort studies.…”

Section: Predictors Of Ppm Implantation After Tavrmentioning

confidence: 99%

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Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population

Zhang

Chi

Tian

et al. 2022

Front. Cardiovasc. Med.

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Background: Permanent pacemaker (PPM) implantation is the main complication of transcatheter aortic valve replacement (TAVR). Few studies have evaluated the requirement for PPM implantation due to ECG changes following TAVR in a Chinese population.Objective: Our study aimed to evaluate the incidence and predictors of PPM implantation in a cohort of Chinese patients with TAVR.Methods: We retrospectively evaluated 39 consecutive patients with severe native aortic stenosis referred for TAVR with a self-expandable prosthesis, the Venus A valve (Venus MedTech Inc., Hangzhou, China), from 2019 to 2021 at the Heart Center of Affiliated Zhongshan Hospital of Dalian University. Predictors of PPM implantation were identified using logistic regression.Results: In our study, the incidence of PPM implantation was 20.5%. PPM implantation occurs with higher risk in patients with negative creatinine clearance (CrCl), dyslipidemia, high Society of Thoracic Surgeons (STS) Morbimortality scores, and lead I T wave elevation. TAVR induced several cardiac electrical changes such as increased R wave and T wave changes in lead V5. The main independent predictors of PPM implantation were new-onset left bundle branch block (LBBB) (coef: 3.211, 95% CI: 0.899–7.467, p = 0.004) and lead I T wave elevation (coef: 11.081, 95% CI: 1.632–28.083, p = 0.016).Conclusion: New-onset LBBB and lead I T wave elevation were the main independent predictors of PPM implantation in patients undergoing TAVR. Clinical indications such as negative CrCl, dyslipidemia, high STS Morbimortality scores, and an increased T wave elevation before TAVR should be treated with caution to decrease the need for subsequent PPM implantation.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population

Zhang

Chi

Tian

et al. 2022

Front. Cardiovasc. Med.

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“…EVO-LUTE LOW-RISK and PARTNER-3 studies have shown that TAVI is not inferior to SAVR, even in low-risk patients [71][72][73]. However, TAVI is associated with risks such as death, bleeding complications, atrioventricular blocks requiring a pacemaker, and stroke [74][75][76].…”

Section: Diagnosis and Treatment Of Aortic Stenosismentioning

confidence: 99%

Lp(a) in the Pathogenesis of Aortic Stenosis and Approach to Therapy with Antisense Oligonucleotides or Short Interfering RNA

Di Costanzo,

Indolfi,

Franzone

et al. 2023

IJMS

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To date, no medical therapy can slow the progression of aortic stenosis. Fibrocalcific stenosis is the most frequent form in the general population and affects about 6% of the elderly population. Over the years, diagnosis has evolved thanks to echocardiography and computed tomography assessments. The application of artificial intelligence to electrocardiography could further implement early diagnosis. Patients with severe aortic stenosis, especially symptomatic patients, have valve repair as their only therapeutic option by surgical or percutaneous technique (TAVI). The discovery that the pathogenetic mechanism of aortic stenosis is similar to the atherosclerosis process has made it possible to evaluate the hypothesis of medical therapy for aortic stenosis. Several drugs have been tested to reduce low-density lipoprotein (LDL) and lipoprotein(a) (Lp(a)) levels, inflammation, and calcification. The Proprotein Convertase Subtilisin/Kexin type 9 inhibitors (PCSK9-i) could decrease the progression of aortic stenosis and the requirement for valve implantation. Great interest is related to circulating Lp(a) levels as causally linked to degenerative aortic stenosis. New therapies with ASO (antisense oligonucleotides) and siRNA (small interfering RNA) are currently being tested. Olpasiran and pelacarsen reduce circulating Lp(a) levels by 85–90%. Phase 3 studies are underway to evaluate the effect of these drugs on cardiovascular events (cardiovascular death, non-fatal myocardial injury, and non-fatal stroke) in patients with elevated Lp(a) and CVD (cardiovascular diseases). For instance, if a reduction in Lp(a) levels is associated with aortic stenosis prevention or progression, further prospective clinical trials are warranted to confirm this observation in this high-risk population.

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Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation

Tomii

Okuno

Heg

et al. 2022

Archives of Cardiovascular Diseases

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Incidence, predictors and clinical impact of permanent pacemaker insertion in women following transcatheter aortic valve implantation: Insights from a prospective multinational registry

Cited by 6 publications

References 47 publications

Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population

Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population

Lp(a) in the Pathogenesis of Aortic Stenosis and Approach to Therapy with Antisense Oligonucleotides or Short Interfering RNA

Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation

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