Incidence, predictors, and clinical outcomes of permanent pacemaker insertion following transcatheter aortic valve implantation in an Arab population

Rajah, Fares Tofailahmed; Alaamiri, Abdulkhaliq; Mahmoodurrahman, Mohammed; Alhowaish, Thamer Saad; Aldosari, Shaya Fahad; Hussain, Abdulwahab; Masuadi, Emad; Arifi, Ahmed A.; Balgaith, Mohammed; Ayoub, Kamal; Almutairi, Fawaz; Alanazi, Haitham

doi:10.1007/s10840-021-01039-2

Cited by 2 publications

(1 citation statement)

References 31 publications

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“…32 In addition, diabetes was found to be associated with increased risk of LBBB after TAVR. 33 While diabetes mellitus was a negative predictor for PPM implantation after TAVR in a study including 170 patients, 34 the larger cohort of our study could explain this discrepancy. Omer et al in their analysis of 4955 hospitalization for TAVR showed similar readmission outcomes in patients discharged early (<3 days) compared to late (≥3 days).…”

Section: Discussionmentioning

confidence: 59%

Early versus late discharge after transcatheter aortic valve replacement and readmissions for permanent pacemaker implantation

Elzanaty

Maraey

Elbadawi

et al. 2022

Cathet Cardio Intervent

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Objective To examine the rate of readmission for permanent pacemaker (PPM) implantation with early versus late discharge after transcatheter aortic valve replacement (TAVR). Background There is a current trend toward early discharge after TAVR. However, paucity of data exists on the impact of such practice on readmissions for PPM implantation. Methods The Nationwide Readmission Database 2016–2018 was queried for all hospitalizations where patients underwent TAVR. Hospitalizations were stratified into early (Days 0 and 1) versus late (≥Day 2) discharge groups. Observations in which PPM was required in the index admission were excluded. Multivariable regression analyses involving patient‐ and hospital‐related variables were utilized. The primary outcome was 90‐day readmission for PPM implantation. Results The final analysis included 68,482 TAVR hospitalizations, 20,261 (29.6%) with early versus 48,221 (70.4%) with late discharge. Early discharge after TAVR increased over the study period (16.2% in 2016 vs. 37.9% in 2018, Ptrend < 0.01). Nevertheless, 90‐day readmission for PPM implantation remained stable (1.8% in 2016 vs. 2.0% in 2018, Ptrend = 0.32). The 90‐day readmission rate for PPM implantation (2.0% vs. 1.8%; adjusted odds ratio: 1.15; 95% confidence interval: 0.95–1.39; p = 0.15) and median time‐to‐readmission (5 days [interquartile range, IQR 3–9] vs. 5 days [IQR 3–14], p = 0.92) were similar with early versus late discharge. Similar rates were observed regardless of whether readmission was elective versus not. Early discharge was associated with lower hospitalization cost ($39,990 ± $13,681 vs. $46,750 ± $18,218, p < 0.01) compared with late discharge. Conclusion In patients who did not require PPM during the index TAVR hospitalization, the rate of readmission for PPM implantation was similar with early versus late discharge.

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Section: Discussionmentioning

confidence: 59%

Early versus late discharge after transcatheter aortic valve replacement and readmissions for permanent pacemaker implantation

Elzanaty

Maraey

Elbadawi

et al. 2022

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Mid- to Long-Term Clinical and Echocardiographic Effects of Post-procedural Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Zhang

et al. 2022

Front. Cardiovasc. Med.

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AimsTo date, the prognostic effects of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) remain controversial. The purpose of this meta-analysis was to investigate the mid- (1 year) to long-term (> 1 year) clinical and echocardiographic effects of post-procedural PPI in patients after TAVR.MethodsPubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched from the establishment of databases up to 1 December 2021. Studies comparing clinical and echocardiographic outcomes between patients with and without post-TAVR PPI of ≥ 1-year follow-up were collected for further meta-analysis.ResultsA total of 39 studies comprising of 83,082 patients were included in this meta-analysis. At mid-term follow-up (1 year), the pooled results demonstrated a higher risk of all-cause mortality in patients with post-procedural PPI than those without following TAVR (relative risk (RR), 1.17; 95% CI, 1.10–1.24; P < 0.00001). No significant differences were observed in cardiovascular mortality (RR, 0.86; 95% CI, 0.71–1.03; P = 0.10) or heart failure rehospitalization (RR, 0.91; 95% CI, 0.58–1.44; P = 0.69) at 1-year follow-up. At long-term follow-up (> 1 year), post-TAVR PPI had negative effects on all-cause mortality (RR, 1.18; 95% CI, 1.09–1.28; P < 0.0001) and heart failure rehospitalization (RR, 1.42; 95% CI, 1.18–1.71; P = 0.0002). There was no difference in long-term cardiovascular mortality between the two groups (RR, 1.15; 95% CI, 0.97–1.36; P = 0.11). Left ventricular ejection fraction (LVEF) was not significantly different at baseline (mean difference, 1.40; 95% CI, –0.13–2.93; P = 0.07), but was significantly lower in the PPI group at 1-year follow-up (mean difference, –3.57; 95% CI, –4.88 to –2.26; P < 0.00001).ConclusionOur meta-analysis provides evidence that post-TAVR PPI has negative clinical and echocardiographic effects on patients at mid- to long-term follow-up. Further studies are urgently needed to explore the cause of these complications and optimize the treatment and management of patients requiring permanent pacing after TAVR.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289935], identifier [CRD42021289935].

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Incidence, predictors, and clinical outcomes of permanent pacemaker insertion following transcatheter aortic valve implantation in an Arab population

Cited by 2 publications

References 31 publications

Early versus late discharge after transcatheter aortic valve replacement and readmissions for permanent pacemaker implantation

Early versus late discharge after transcatheter aortic valve replacement and readmissions for permanent pacemaker implantation

Mid- to Long-Term Clinical and Echocardiographic Effects of Post-procedural Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

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