New Pacemaker Implantation in Patients undergoing Transcatheter Valve Replacement: a systematic review and meta-analysis

Abstract

BackgroundPermanent pacemaker (PPM) implantation remain a common finding after Transcatheter aortic valve replacement (TAVR). Overall rate of PPM implantation after TAVR varies and is related to various factors and is highly variable. The purpose of this review is to evaluate the incidence of new permanent pacemaker implant at 1 year irrespective of valve brand manufacturer, vascular access used, deployment technique/mechanism. Secondary outcomes included all-cause mortality, 30-day, 1-year mortality, and cardiovascular mortality.MethodsWe performed a systematic search for studies that reported the incidence of PPM implantation after TAVR. Data on study, patient, and procedural characteristics were abstracted. Risk ratios (RRs); odds ratio (OR) and 95% confidence intervals were calculated by use of random effects models.Results14 studies were included, totalling 25,967 TAVR patients, mean age 80.15 ± 6.91years, 52.9% being male, 26.3% of which required PPM implantation 1-year after intervention (p = 0.00001; RR 115.16).ConclusionsVarious factors impact the risk for pacemaker implantation after TAVR and one quoter of the patients undergo new permanent pacemaker implant at 1-year post undergoing TAVR.

Two Examples of Legal Transplants in Chilean Consumer Law

“…28 In this line, during the reform processes or drafting of laws they can serve as a true instrument of legislative policy. 29 Beyond the theoretical importance of the issue of legal transplants, the study of these phenomena constitutes a contribution to knowledge, since the conditions under which a foreign legal provision is adopted in Chilean consumer law are not known, nor are the consequences of that adoption.…”