Related Experiment Video

Updated: Jan 15, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

1.6K

Preprocedural CT and ECG Markers for Predicting Post-TAVR Pacemaker Requirement in High-Risk Patients

Justin T Tretter1, Mackram F Eleid2, Francesco Bedogni3

  • 1Hobart Healthcare Research Institute, London, UK.

Structural Heart : the Journal of the Heart Team
|October 15, 2025
PubMed

Insights

A new model predicts permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) using CT and ECG data. This tool helps identify patients at higher risk for PPI, improving procedural planning.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Permanent pacemaker implantation (PPI) is a frequent complication after transcatheter aortic valve replacement (TAVR).
  • Accurate prediction of PPI risk is crucial for patient management and procedural optimization.

Purpose of the Study:

  • To develop and evaluate a predictive model for PPI following TAVR.
  • To integrate computed tomography (CT)-based anatomical and electrocardiogram (ECG)-based parameters for enhanced prediction accuracy.

Main Methods:

  • Assessed CT-derived anatomical parameters, focusing on the conduction axis relative to the aortic virtual basal ring.
  • Combined electrophysiological variables with anatomical data to build a predictive model for post-TAVR PPI.
  • Utilized multiple binary logistic regression to identify significant predictors and assess model performance (AUC, sensitivity, specificity).

Main Results:

  • The predictive model identified several key factors associated with increased PPI risk, including membranous septum position and specific preprocedural ECG findings (right bundle branch block, first-degree AV block).
  • A shallower membranous septum inferior margin midpoint increased PPI odds by 20% per millimeter.
  • The model achieved an area under the curve (AUC) of 0.73, indicating moderate predictive capability.

Conclusions:

  • A novel predictive model combining anatomical and electrical parameters can estimate PPI risk after TAVR.
  • This model offers a valuable tool for risk stratification and procedural planning in TAVR patients.
  • Further prospective validation is necessary to confirm the model's real-world clinical utility and performance.
Abstract

Keywords:
Computed tomographyConduction damageElectrocardiogramHeart blockPacemakerTranscatheter aortic valve implantationTranscatheter aortic valve replacement

More Related Videos

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction06:57

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

15.2K
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

4.2K

Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
465
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.1K
Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
5.4K
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
280
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
213