Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Cost Analysis

Area of Science:

• Cardiology
• Health Economics

Background:

• Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic valve stenosis.
• Complete atrioventricular block is a known complication of TAVR, necessitating permanent pacemaker (PPM) implantation.
• The economic implications of PPM implantation following TAVR are not well-defined.

Purpose of the Study:

• To analyze the detailed cost associated with permanent pacemaker (PPM) implantation in patients undergoing transcatheter aortic valve replacement (TAVR).
• To quantify the increased hospitalization costs for TAVR patients who require PPM implantation.

Main Methods:

• Retrospective analysis of 382 patients undergoing TAVR between December 2012 and April 2018.
• Patients were divided into two groups: those requiring PPM after TAVR and those who did not.
• Hospitalization costs were categorized into direct and indirect costs.

Main Results:

• 19 (4.9%) of 382 TAVR patients required PPM implantation.
• The PPM group experienced significantly longer intensive care unit (ICU) and total hospital stays.
• PPM implantation increased average hospitalization costs by $10,213 (p=0.04), with a significant increase in direct costs ($7,087; p=0.02).

Conclusions:

• Permanent pacemaker implantation following TAVR significantly increases the overall cost of hospitalization.
• Healthcare providers and policymakers should consider this additional cost burden when evaluating TAVR outcomes and resource allocation.