Transcatheter Aortic Valve Implantation and Requirements of Pacing Over Time

Pereira, Eulália; Ferreira, Nuno; Caeiro, Daniel; Primo, João; Adão, Luís; Oliveira, Marco; Gonçalves, Helena; Ribeiro, José; Santos, Emanuel; Leite, Daniel; Bettencourt, Nuno; Braga, Pedro; Simões, Lino; Vouga, Luís; Gama, Vasco

doi:10.1111/pace.12104

Cited by 61 publications

(42 citation statements)

References 29 publications

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“…However, these finding are consistent with prior studies in the cardiac surgery field, 22 as well as with some prior smaller TAVI series. [8][9][10][11] Results from the Dual Chamber and VVI Implantable Defibrillator (DAVID) trial, Mode Selection Trial (MOST), and Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II) showed that the deleterious impact of pacing on heart failure or mortality depends on cumulative percent time of ventricular pacing. Specifically, a right ventricular pacing during ≥40% to 50% of the time was associated with increased risk of heart failure or mortality.…”

Section: Ppi After Tavi and Clinical Outcomesmentioning

confidence: 99%

“…[8][9][10][11] Although these studies did not find any impact of PPI on mortality, concerns that they may have been underpowered as a result of inadequate sample size have been raised. 12 In addition, no studies to date have evaluated the impact of PPI on rehospitalizations resulting from heart failure, left ventricular function changes, and sudden death.…”

mentioning

confidence: 94%

“…12 In addition, no studies to date have evaluated the impact of PPI on rehospitalizations resulting from heart failure, left ventricular function changes, and sudden death. Finally, the vast majority of patients included in studies evaluating the impact of PPI after TAVI had received a SEV, [8][9][10][11] and very few data exist on patients who received a BEV. Therefore, the aims of this study were to assess in a large cohort of patients undergoing TAVI with BEV and SEV the impact of new PPI on late outcomes (including mortality and rehospitalization for heart failure) and left ventricular function and functional status changes after the intervention.…”

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confidence: 99%

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Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation

et al. 2014

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T ranscatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with aortic stenosis who are considered to be nonoperable and a good alternative for those at high surgical risk.1 However, the occurrence of some periprocedural complications remains a concern. The need for permanent pacemaker implantation (PPI) after the procedure is one of the most frequent complications associated with TAVI, with an overall incidence of ≈15% (≈25% and 7% after TAVI with self-expandable valves [SEVs] and balloon-expandable valves [BEVs], respectively). 1 Clinical Perspective on p 1243Strong evidence supports the potential negative impact of right ventricular apical pacing, which has been associated with an increased rate of the combined end point of mortality and rehospitalization for heart failure in patients with left ventricular dysfunction, 2-4 ventricular tachyarrhythmias, 5,6 and pacing-induced cardiomyopathy in patients without overt structural heart disease. 7 However, evidence for the clinical impact of PPI after TAVI remains scarce and based on small Background-Very few data exist on the clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation. The objective of this study was to assess the impact of PPI after transcatheter aortic valve implantation on late outcomes in a large cohort of patients. =0.121). Conclusions-The need for PPI was a frequent complication of transcatheter aortic valve implantation, but it was not associated with any increase in overall or cardiovascular death or rehospitalization for heart failure after a mean follow-up of ≈2 years. Indeed, 30-day PPI was a protective factor for the occurrence of unexpected (sudden or unknown) death.

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Section: Ppi After Tavi and Clinical Outcomesmentioning

confidence: 99%

mentioning

confidence: 94%

mentioning

confidence: 99%

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Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation

et al. 2014

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“…The center of the diamond represents the point estimate, and the width represents 95% confidence interval (CI). Studies included in these analyses are Fadahunsi et al, 12 Dizon et al, 13 Biner et al, 14 D'Ancona et al, 23 De Carlo et al, 24 Houthuizen et al, 25 Buellesfeld et al, 26 Van Mieghem et al, 28 Pereira et al, 30 Schymik et al, 32 Maan et al, 33 Kostopoulou et al, 34 Mouillet et al, 35 Engborg et al, 36 and Kawaguchi et al 37 …”

Section: Study Analysismentioning

confidence: 99%

“…In addition, for calculation of improvement in LVEF, there were 3 studies 16,17,21 where SDs for change (improvement) in LVEF were not available. Here, we imputed the SD based on other studies in the meta-analysis with similar follow-up duration based on guidelines 12 Dizon et al, 13 Biner et al, 14 D'Ancona et al, 23 De Carlo et al, 24 Houthuizen et al, 25 Buellesfeld et al, 26 Van Mieghem et al, 28 Pereira et al, 30 Schymik et al, 32 Maan et al, 33 Kostopoulou et al, 34 Mouillet et al, 35 Engborg et al, 36 and Kawaguchi et al 37 CI indicates confidence interval; MH, Mantel-Haenszel; and PPM, permanent pacemaker. Impact of Post-TAVR Pacemaker for systematic reviews provided by the Cochrane Collaboration.…”

Section: Study Analysismentioning

confidence: 99%

Clinical and Echocardiographic Outcomes Following Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement

Mohananey

Jobanputra

Kumar

et al. 2017

Circ: Cardiovascular Interventions

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Background— Transcatheter aortic valve replacement has become the procedure of choice for inoperable, high-risk, and many intermediate-risk patients with aortic stenosis. Conduction abnormalities are a common finding after transcatheter aortic valve replacement and often result in permanent pacemaker (PPM) implantation. Data pertaining to the clinical impact of PPM implantation are controversial. We used meta-analysis techniques to summarize the effect of PPM implantation on clinical and echocardiographic outcomes after transcatheter aortic valve replacement. Methods and Results— Data were summarized as Mantel–Haenszel relative risk (RR) and 95% confidence intervals (CIs) for dichotomous variables and as standardized mean difference and 95% CI for continuous variables We used the Higgins I 2 statistic to evaluate heterogeneity. We found that patients with and without PPM have similar all-cause mortality (RR, 0.85; 95% CI, 0.70–1.03), cardiovascular mortality (RR, 0.84; 95% CI, 0.59–1.18), myocardial infarction (RR, 0.47; 95% CI, 0.20–1.11), and stroke (RR, 1.26; 95% CI, 0.70–2.26) at 30 days. The groups were also comparable in all-cause mortality (RR, 1.03; 95% CI, 0.92–1.16), cardiovascular mortality (RR, 0.69; 95% CI, 0.39–1.24), myocardial infarction (RR, 0.58; 95% CI, 0.30–1.13), and stroke (RR, 0.70; 95% CI, 0.47–1.04) at 1 year. We observed that the improvement in left ventricular ejection fraction was significantly greater in the patients without PPM (standardized mean difference, 0.22; 95% CI, 0.12–0.32). Conclusions— PPM implantation is not associated with increased risk of all-cause mortality, cardiovascular mortality, stroke, or myocardial infarction both at short- and long-term follow-up. However, PPM is associated with impaired left ventricular ejection fraction recovery post-transcatheter aortic valve replacement.

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