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Updated: Jul 4, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Pacemaker Status and 5-Year Mortality After TAVI: A Sex-Specific Analysis
Cecilia Veraar1, Gudrun Lamm1, Maximilian Will1
1Department of Internal Medicine 3, University Hospital St. Pölten - NOE LGA, Karl Landsteiner University, St. Pölten, Austria.
European Journal of Clinical Investigation
|July 3, 2026
Summary
Pacemaker implantation after TAVI impacts survival differently by sex. Post-procedural pacemakers (PM) worsen 30-day survival in women, while pre-existing PMs reduce 5-year survival in men.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Electrophysiology
Background:
- The prognostic impact of permanent pacemaker (PM) implantation following transcatheter aortic valve implantation (TAVI) shows unexplored sex-specific differences.
- Understanding these differences is crucial for optimizing patient care and outcomes after TAVI.
Purpose of the Study:
- To investigate sex-specific associations between pre-existing and new post-procedural PM implantation and short- and long-term mortality after TAVI.
- To determine if PM status influences mortality differently in men and women undergoing TAVI.
Main Methods:
- A post hoc analysis of a prospective registry of TAVI patients (2016-2020).
- Patients were stratified by sex and categorized into three groups: no PM, pre-existing PM (pre-PM), or PM implantation within 30 days (post-PM).
- Primary endpoint: 5-year all-cause mortality; Secondary endpoint: 30-day mortality. Sex-stratified analyses were performed.
Main Results:
- Women were more likely to have no PM and less likely to have a pre-PM compared to men. Post-PM rates were similar between sexes.
- Thirty-day survival was worse in women with post-PM (log-rank p=0.033), but not in men (p=0.542).
- Five-year survival did not differ by PM status in women (p=0.572) but was significantly reduced in men with pre-PM (p<0.001).
Conclusions:
- Post-procedural PM implantation is linked to higher 30-day mortality in women undergoing TAVI.
- Pre-existing PM predicts reduced 5-year survival in men after TAVI.
- These findings support the need for sex-specific risk assessment before and after TAVI procedures.
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