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Pacemaker post transcatheter aortic valve replacement: A multifactorial risk?

Stephane Noble1, Karim Bendjelid2

  • 1Department of Medicine, Structural Heart Unit, University Hospital of Geneva, Geneva 1211, Switzerland. stephane.noble@hcuge.ch.

World Journal of Cardiology
|May 1, 2024
PubMed
Summary

Pacemaker implantation after transcatheter aortic valve replacement involves multiple factors. Procedural details significantly influence the need for a permanent pacemaker and pacing rates, highlighting the importance of long-term monitoring.

Keywords:
Conduction abnormalitiesLeft bundle branch blockPermanent pacemaker implantationRight bundle branch blockTranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Pacemaker implantation following TAVR is a known complication with multifactorial causes.
  • Previous research has focused on electrocardiogram and clinical predictors.

Discussion:

  • Procedural characteristics, beyond clinical factors, significantly impact the need for permanent pacemaker (PPM) post-TAVR.
  • Understanding the influence of specific procedural elements is crucial for risk stratification.
  • The rate of pacing is also potentially affected by procedural aspects.

Key Insights:

  • Procedural characteristics are as critical as clinical factors in determining PPM need after TAVR.
  • Specific procedural details require further investigation to predict and mitigate PPM necessity.
  • Long-term follow-up is essential to understand the consequences of permanent pacing.

Outlook:

  • Further research should focus on quantifying the impact of individual procedural variables on PPM rates.
  • Developing algorithms that incorporate procedural data may improve patient selection and outcomes.
  • Long-term studies are needed to assess the clinical implications of chronic pacing in this population.