Permanent Pacemaker Lead Insertion Connected to an External Pacemaker Generator for Temporary Pacing After Transcatheter Aortic Valve Implantation

Goncalves, Cristian Rodrigues; Bertog, Stefan; Tholakanahalli, Venkatakrishna N.; Römer, Albrecht; Hofmann, Ilona; Reinartz, Markus; Gafoor, Sameer; Sievert, Kolja; Schnelle, Nalan; Grunwald, Iris Q.; Sievert, Horst

doi:10.1016/j.carrev.2020.02.002

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…Recently, TPPM has also been used in patients with conduction block after TAVR, Goncalves et al conducted a retrospective analysis of 114 patients ( 21 ), TPPM were routinely placed prior to arterial access and valve deployment in all patients, it was left in place on average for 4.4 days, permanent pacemaker was implanted in ten patients (9%) with conduction abnormality persisted for at least 24 h. Given the retrospective nature of the study and no follow up data, it is not possible to analyze whether there were patients who had a HAVB after TAVR with spontaneous recovery. So, the focus was feasibility and safety.…”

Section: Discussionmentioning

confidence: 99%

Feasibility study of temporary permanent pacemaker in patients with conduction block after TAVR

Chang

Liu

et al. 2023

Front. Cardiovasc. Med.

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BackgroundLimited data exist on the use of temporary permanent pacemaker (TPPM) to reduce unnecessary PPM in patients with high-degree atrioventricular block (HAVB) after transcatheter aortic valve replacement (TAVR).ObjectivesThis study aims to determine the feasibility of TPPM in patients with HAVB after TAVR to provide prolonged pacing as a bridge.Materials and methodsOne hundred and eleven consecutive patients undergoing TAVR were screened from August 2021 to June 2022. Patients with HAVB eligible for PPM were included. TPPM were used in these patients instead of conventional temporary pacing or early PPM. Patients were followed up for 1 month. Holter and pacemaker interrogation were used to determine whether to implant PPM.ResultsTwenty one patients met the inclusion criteria for TPPM, of which 14 patients were third-degree AVB, 1 patient was second-degree AVB, 6 patients were first degree AVB with PR interval > 240 ms and LBBB with QRS duration > 150 ms. TPPM were placed on the 21 patients for 35 ± 7 days. Among 15 patients with HAVB, 26.7% of them (n = 4) recovered to sinus rhythm; 46.7% (n = 7) recovered to sinus rhythm with bundle branch block. The remains of 26.7% patients (n = 4) still had third-degree AVB and received PPM. For patients with first-degree AVB and LBBB, PR interval shortened to < 200 ms in all 6 patients and LBBB recovered in 2 patients. TPPM were successfully removed from all patients and no procedure-related adverse events occurred.ConclusionTPPM is reliable and safe in the small sample of patients with conduction block after TAVR to provide certain buffer time to distinguish whether a PPM is necessary. Future studies with larger sample are needed for further validation of the current results.

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Section: Discussionmentioning

confidence: 99%

Feasibility study of temporary permanent pacemaker in patients with conduction block after TAVR

Chang

Liu

et al. 2023

Front. Cardiovasc. Med.

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“…A temporary pacemaker lead can only be used for a limited duration due to the risk of infection. Therefore, a semi-permanent pacemaker lead insertion [ 16 ] or a leadless pacemaker may be an option for patients who develop acute conduction disorders post-TAVR. This can prevent complications related to the pacemaker pocket.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker dependency after transcatheter aortic valve replacement compared to surgical aortic valve replacement

Hwang

Kim²,

Nam³

et al. 2021

Medicine

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Transcatheter aortic valve replacement (TAVR) is a standard treatment indicated for severe aortic stenosis in high-risk patients. The objective of this study was to evaluate the incidence of pacemaker dependency after permanent pacemaker implantation (PPI) following TAVR or surgical aortic valve replacement (SAVR) and the risk of mortality at a tertiary center in Korea. In this retrospective study conducted at a single tertiary center, clinical outcomes related to pacemaker dependency were evaluated for patients implanted with pacemakers after TAVR from January 2012 to November 2018 and post-SAVR from January 2005 to May 2015. Investigators reviewed patients’ electrocardiograms and baseline rhythms as well as conduction abnormalities. Pacemaker dependency was defined as a ventricular pacing rate > 90% with an intrinsic rate of <40 bpm during interrogation. Of 511 patients who underwent TAVR for severe AS, 37(7.3%) underwent PPI after a median duration of 6 (3–7) days, whereas pacemakers were implanted after a median interval of 13 (8–28) days post-SAVR in 10 of 663 patients ( P < .001). Pacemaker dependency was observed in 36 (97.3%) patients during 7 days immediately post-TAVR and in 25 (64.9%) patients between 8 and 180 days post-TAVR. Pacemaker dependency occurred after 180 days in 17 (50%) patients with TAVR and in 4 (44.4%) patients with SAVR. Twelve (41.4%) patients were pacemaker-dependent after 365 days post-TAVR. Pacemaker dependency did not differ at 6 months after TAVR vs SAVR. In patients undergoing post-TAVR PPI, 58.6% were not pacemaker-dependent at 1 year after the TAVR procedure.

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“…However, the available data are still limited to case series or retrospective study. 11 , 12 Therefore, this multi-centre study aimed to explore the efficacy of the use of a TPPM in reducing the rate of PPM implantation in a large patient population. We investigated the occurrence and recovery time of conduction disturbances for up to 30 days after TAVR.…”

Section: Introductionmentioning

confidence: 99%

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

Chang,

Jiang,

Liu

et al. 2024

eClinicalMedicine

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Permanent Pacemaker Lead Insertion Connected to an External Pacemaker Generator for Temporary Pacing After Transcatheter Aortic Valve Implantation

Cited by 7 publications

References 9 publications

Feasibility study of temporary permanent pacemaker in patients with conduction block after TAVR

Feasibility study of temporary permanent pacemaker in patients with conduction block after TAVR

Pacemaker dependency after transcatheter aortic valve replacement compared to surgical aortic valve replacement

Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

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