Related Experiment Video
Updated: Mar 15, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement
Jonathan Engborg1, Casper Riechel-Sarup1, Oke Gerke2
1a Department of Cardiology , Odense University Hospital , Odense C , Denmark.
Objectives:
Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records. Kaplan-Meier plots and Cox regression analysis were performed.
Results:
Forty subjects were excluded, leaving 128 patients for final inclusion. 41 (32%) received a PPM (mean age 82 vs. 80 in patients without PPM, p = .06) within 30 days of the TAVI procedure. Median follow-up was ∼4 years and 37 (29%) died. One-year mortality was 14% for non-PPM patients vs. 2% in PPM patients, and mortality at 5yrs 70% vs. 54%, respectively. Kaplan-Meier survival analysis showed higher mortality in patients without PPM (p = .008). In multivariate survival analysis significant variables were: No PPM (HR 2.6; CI 1.1-6.2; p = .03), chronic obstructive pulmonary disease (HR 2.4; CI 1.2-5.0; p = .02) and either pre- or post-procedural chronic or paroxystic atrial fibrillation (HR 2.3; CI 1.2-4.7; p= .02).
Conclusion:
TAVI-patients with a PPM had better survival than patients in whom a PPM was not implanted.
