Atrial Fibrillation is Associated with Increased Pacemaker Implantation Rates in the Placement of AoRTic Transcatheter Valve (PARTNER) Trial

Biviano, Angelo; Nazif, Tamim; Dizon, José; Garan, Hasan; Abrams, Mark P.; Fleitman, Jessica; Hassan, Dua; Kapadia, Samir; Babaliaros, Vasilis; Xu, Ke; Rodés‐Cabau, Josep; Szeto, Wilson Y.; Fearon, William F.; Dvir, Danny; Dewey, Todd M.; Williams, Mathew; Kindsvater, Steven; Webb, John G.; Miller, D. Craig; Smith, Craig R.; Leon, Martin B.; Kodali, Susheel

doi:10.4022/jafib.1494

Cited by 12 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, incident atrial fibrillation post‐TAVR was associated with the need for PPM implantation at 30 days and 1 year in the PARTNER cohort (compared with those maintaining either sinus rhythm or atrial fibrillation pre‐ and postprocedure). Baseline atrial fibrillation, however, was not associated with the need for PPM implantation . We suspect that the absence of sinus rhythm in our cohort is a marker of cardiac conduction system disease that is mediated by fibrosis or some other factor, although this remains to be further investigated.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Factors predicting persistence of AV nodal block in post‐TAVR patients following permanent pacemaker implantation

Lader

Barbhaiya

Subnani

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Introduction A common complication of transcatheter aortic valve repair (TAVR) is development of conduction defects requiring pacemaker (PPM) implantation. These defects are not universally permanent. Objective To determine the incidence and predictors of persistent device dependency in patients with PPM implantation following TAVR with a self‐expanding prosthesis. Methods Records of patients who underwent post‐TAVR PPM implantation were reviewed. Patients with persistent complete AV block (AVBIII) one month post‐TAVR were compared to those regaining conduction. Results Between September 2014 and March 2017, 485 patients underwent TAVR with a self‐expanding prosthesis; 77 (15.9%) underwent PPM implantation for AVBIII. Device interrogation at one month was available for 61 patients (79%): 22 (36.1%) had resolution of AVBIII while 39 (63.9%) remained pacemaker‐dependent. Pre‐TAVR right bundle branch block was more frequent in device‐dependent patients (19 of 38, 50% vs 4 of 22, 18%; RR 2.75; P = .01). Device‐dependence was associated with AVBIII as the first postprocedural rhythm (37 of 39, 95% vs 12 of 22, 55%; RR 1.74; P < .0001), earlier implantation (median 1d, IQR: 0‐1.5d vs 2d, IQR: 1.0‐4.0d, P = .0004), and a shorter duration of hospitalization (median 3d, IQR: 2‐3.5d vs 4d, IQR: 2‐5.75d, P = .03). Pacemaker dependence was also associated with a higher prosthesis‐to left ventricular outflow tract (LVOT) diameter (1.45 ± 0.11 vs 1.39 ± 0.07; P = .02) and the lack of prior aortic valvuloplasty (5 of 39, 13% vs 8 of 22, 36%; RR 0.35; P = .03). Conclusions In patients receiving a PPM following self‐expanding TAVR, a long‐term pacing requirement can be predicted from the timing of AV block, existing conduction‐system disease, larger prosthesis‐to‐LVOT diameter, and the lack of aortic valvuloplasty.

show abstract

Section: Discussionmentioning

confidence: 78%

“…Baseline atrial fibrillation, however, was not associated with the need for PPM implantation. 20 We suspect that the absence of sinus rhythm in our cohort is a marker of cardiac conduction system disease that is mediated by fibrosis or some other factor, 21 although this remains to be further investigated.…”

Section: Discussionmentioning

confidence: 89%

Factors predicting persistence of AV nodal block in post‐TAVR patients following permanent pacemaker implantation

Lader

Barbhaiya

Subnani

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…These findings were in line with the previous literature that also demonstrated an identical rate of need for PPM. 94 While a subset of the PARTNER registry showed that patients with sinus rhythm before TAVR and AF at discharge were twice more likely to get a PPM, patients with chronic AF had <6% risk of PPM, not significantly different from patients having no‐AF at baseline. 94 …”

Section: Discussionmentioning

confidence: 96%

Predictors of Permanent Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement ‐ A Systematic Review and Meta‐Analysis

Ullah

Zahid

Zaidi

et al. 2021

JAHA

View full text Add to dashboard Cite

Background As transcatheter aortic valve replacement (TAVR) technology expands to healthy and lower‐risk populations, the burden and predictors of procedure‐related complications including the need for permanent pacemaker (PPM) implantation needs to be identified. Methods and Results Digital databases were systematically searched to identify studies reporting the incidence of PPM implantation after TAVR. A random‐ and fixed‐effects model was used to calculate unadjusted odds ratios (OR) for all predictors. A total of 78 studies, recruiting 31 261 patients were included in the final analysis. Overall, 6212 patients required a PPM, with a mean of 18.9% PPM per study and net rate ranging from 0.16% to 51%. The pooled estimates on a random‐effects model indicated significantly higher odds of post‐TAVR PPM implantation for men (OR, 1.16; 95% CI, 1.04–1.28); for patients with baseline mobitz type‐1 second‐degree atrioventricular block (OR, 3.13; 95% CI, 1.64–5.93), left anterior hemiblock (OR, 1.43; 95% CI, 1.09–1.86), bifascicular block (OR, 2.59; 95% CI, 1.52–4.42), right bundle‐branch block (OR, 2.48; 95% CI, 2.17–2.83), and for periprocedural atriorventricular block (OR, 4.17; 95% CI, 2.69–6.46). The mechanically expandable valves had 1.44 (95% CI, 1.18–1.76), while self‐expandable valves had 1.93 (95% CI, 1.42–2.63) fold higher odds of PPM requirement compared with self‐expandable and balloon‐expandable valves, respectively. Conclusions Male sex, baseline atrioventricular conduction delays, intraprocedural atrioventricular block, and use of mechanically expandable and self‐expanding prosthesis served as positive predictors of PPM implantation in patients undergoing TAVR.

show abstract

“…Incidence of AF increases with age. At the same time, aging population is likely to develop other chronic diseases and one of them is end-stage liver disease or cirrhosis[ 7 - 9 ]. This treatment of cirrhosis comprises of multidisciplinary approach ranging from very simple, symptomatic treatment with diuretic or treatment of primary cause, down the road to the most advanced treatment; liver transplantation[ 10 - 13 ].…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation and atrial fibrillation: A meta-analysis

Chokesuwattanaskul

Thongprayoon

Bathini

et al. 2018

WJH

View full text Add to dashboard Cite

AIMTo assess prevalence of pre-existing atrial fibrillation (AF) and/or incidence of AF following liver transplantation, and the trends of patient’s outcomes overtime; to evaluate impact of pre-existing AF and post-operative AF on patient outcomes following liver transplantation.METHODSA literature search was conducted utilizing MEDLINE, EMBASE and Cochrane Database from inception through March 2018. We included studies that reported: (1) prevalence of pre-existing AF or incidence of AF following liver transplantation; or (2) outcomes of liver transplant recipients with AF. Effect estimates from the individual study were extracted and combined utilizing random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews, No. CRD42018093644).RESULTSTwelve observational studies with a total of 38586 liver transplant patients were enrolled. Overall, the pooled estimated prevalence of pre-existing AF in patients undergoing liver transplantation was 5.4% (95%CI: 4.9%-5.9%) and pooled estimated incidence of AF following liver transplantation was 8.5% (95%CI: 5.2%-13.6%). Meta-regression analyses were performed and showed no significant correlations between year of study and either prevalence of pre-existing AF (P = 0.08) or post-operative AF after liver transplantation (P = 0.54). The pooled OR of mortality among liver transplant recipients with pre-existing AF was 2.34 (2 studies; 95%CI: 1.10-5.00). In addition, pre-existing AF is associated with postoperative cardiovascular complications among liver transplant recipients (3 studies; OR: 5.15, 95%CI: 2.67-9.92, I2 = 64%). With limited studies, two studies suggested significant association between new-onset AF and poor clinical outcomes including mortality, cerebrovascular events, post-transplant acute kidney injury, and increased risk of graft failure among liver transplant recipients (P < 0.05).CONCLUSIONThe overall estimated prevalence of pre-existing AF and incidence of AF following liver transplantation are 5.4% and 8.5%, respectively. Incidence of AF following liver transplant does not seem to decrease overtime. Pre-existing AF and new-onset AF are potentially associated with poor clinical outcomes post liver transplantation.

show abstract

Atrial Fibrillation is Associated with Increased Pacemaker Implantation Rates in the Placement of AoRTic Transcatheter Valve (PARTNER) Trial

Cited by 12 publications

References 31 publications

Factors predicting persistence of AV nodal block in post‐TAVR patients following permanent pacemaker implantation

Factors predicting persistence of AV nodal block in post‐TAVR patients following permanent pacemaker implantation

Predictors of Permanent Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement ‐ A Systematic Review and Meta‐Analysis

Liver transplantation and atrial fibrillation: A meta-analysis

Contact Info

Product

Resources

About