Pacemaker implantation after transcatheter aortic valve implantation

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Transcatheter aortic valve implantation (TAVI) is increasingly used for aortic stenosis.
• A significant percentage of patients require a permanent pacemaker (PPM) post-TAVI due to atrioventricular block (AVB).
• Long-term data on pacing dependency after TAVI are limited.

Purpose of the Study:

• To evaluate the rate of PPM implantation after TAVI at a single center.
• To assess the long-term pacing dependency in patients who received a PPM post-TAVI.
• To investigate the outcomes of PPM implantation following TAVI procedures.

Main Methods:

• Retrospective analysis of 191 TAVI procedures (CoreValve and Edwards SAPIEN) performed between February 2009 and July 2011.
• Identification of patients who received a PPM post-TAVI.
• Follow-up data from pacemaker clinic for up to 103 weeks to determine pacing dependency.

Main Results:

• A PPM was implanted in 16.7% of patients (32/191), with a higher rate in the CoreValve group (30/125) compared to Edwards SAPIEN (2/66).
• Among 27 patients with available follow-up data, only 8 (29%) were pacing dependent after a mean of 52 weeks.
• Complete AVB was the primary indication for PPM in pacing-dependent patients.

Conclusions:

• The PPM implantation rate of 16.7% in this cohort is lower than previously reported.
• Long-term pacing dependency after TAVI is relatively low, with only 29% of PPM recipients requiring permanent pacing.
• Further research is needed to identify predictors for long-term pacing dependency after TAVI.