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Complete atrioventricular block after TAVI: when is pacemaker implantation safe?
Marius Schwerg1, Gerd Baldenhofer, Henryk Dreger
1Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Charité-Universitätsmedizin Berlin, Germany. marius.schwerg@charite.de
Pacing and Clinical Electrophysiology : PACE
|April 24, 2013
Summary
Permanent pacemaker (PPM) implantation after transcatheter aortic valve implantation (TAVI) is safe, even when performed immediately. This study found no increased complications for early PPM implantation in TAVI patients on dual antiplatelet therapy.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Atrioventricular (AV) block is a common complication following transcatheter aortic valve implantation (TAVI).
- TAVI patients often receive anticoagulation, raising concerns about bleeding risks with immediate permanent pacemaker (PPM) implantation.
- Optimal management strategies for TAVI-related AV block require further investigation.
Purpose of the Study:
- To evaluate the safety and complication rates of permanent pacemaker (PPM) implantation in patients who have undergone transcatheter aortic valve implantation (TAVI).
- To compare the outcomes of immediate PPM implantation versus delayed implantation after TAVI.
Main Methods:
- Retrospective analysis of 30 patients who received PPM for TAVI-related AV block between January 2010 and December 2012.
- Patients were divided into two groups: immediate PPM implantation (Group A, n=12) and delayed implantation (Group B, n=18).
- Comparison with a historical cohort undergoing PPM implantation under dual antiplatelet therapy.
Main Results:
- No significant differences in procedure times, fluid loss, or drainage durations were observed between immediate (Group A) and delayed (Group B) PPM implantation.
- PPM implantation following TAVI showed comparable complication rates to a historical control group on dual antiplatelet therapy.
Conclusions:
- Permanent pacemaker implantation immediately after TAVI is a safe procedure.
- Early PPM implantation does not lead to an increased rate of complications in TAVI patients.
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