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Who needs a permanent pacemaker after transcatheter aortic valve implantation?

P Bacik, P Poliacikova, G Kaliska

    Bratislavske Lekarske Listy
    |September 19, 2018
    PubMed

    Insights

    Predictors for pacemaker need after transcatheter aortic valve implantation (TAVI) include atrial fibrillation absence, pulmonary hypertension, obesity, and stenosis severity. Only persistent heart block leads to pacemaker dependency.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Cardiac Surgery

    Background:

    • Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
    • Pacemaker implantation is a known complication following TAVI.
    • Identifying patients at risk for pacemaker dependency is crucial for optimal outcomes.

    Purpose of the Study:

    • To identify factors predicting pacemaker requirement after TAVI.
    • To determine the rate of pacemaker dependency in TAVI patients.

    Main Methods:

    • Retrospective analysis of 116 patients undergoing TAVI.
    • Evaluation of baseline characteristics and procedural data.
    • Correlation of pre-procedural factors with post-TAVI pacemaker need.

    Main Results:

    • Absence of atrial fibrillation, pulmonary hypertension, obesity, and severe aortic stenosis predicted pacemaker need.
    • Persistent periprocedural and early-onset complete heart block were the only indicators of permanent pacemaker dependency.

    Conclusions:

    • While certain factors predict the initial need for a pacemaker post-TAVI, definite predictors for persistent conduction impairment are still needed.
    • Distinguishing between pacemaker dependency and the need for pacing in high-risk patients with borderline indications is essential for improving quality of life by avoiding symptomatic bradycardia.
    Abstract

    Keywords:
    aortic stenosispermanent pacemaker transcatheter aortic valve implantation.

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