Risk for Permanent Pacemaker After Transcatheter Aortic Valve Implantation: A Comprehensive Analysis of the Literature

Erkapic, Damir; Rosa, Salvatore De; Kelava, Augustin; Lehmann, Ralf; Fichtlscherer, Stephan; Hohnloser, Stefan H.

doi:10.1111/j.1540-8167.2011.02211.x

Cited by 201 publications

(136 citation statements)

References 48 publications

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“…The clinical experience and the development of devices that can be more accurately deployed and potentially repositioned had clearly contributed to the decrease of the rate of permanent pacemaker implementation, far from the initial rate close to 40% [36,37].…”

Section: Procedural Features and In-hospital Outcomesmentioning

confidence: 99%

Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world

et al. 2013

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Background: Recently, the use of transcatheter aortic valve implantation (TAVI) in intermediate-low risk patients has been evaluated in the PARTNER ± 9 days after SAVR (p = 0.003). After matched comparison, no differences in terms of in-hospital mortality (5.7% after TAVI vs. 2.9% after SAVR, p = 0.687) and 1-year mortality (11.4% vs. 7.1%, p = 0.381) were found. The combined endpoint of stroke and mortality at 1-year was also similar between both groups (15.7% in TAVI patients vs. 14.4% after SAVR, p = 0.136). Multivariate analysis determined that aortic regurgitation (AR) was an independent predictor of mortality (OR = 3.623, p = 0.016 (Cardiol J 2016; 23, 5: 541-551)

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Section: Procedural Features and In-hospital Outcomesmentioning

confidence: 99%

Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world

et al. 2013

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“…The frequency of pacemaker intervention varies between about 5 to 30% in the literature depending on the TAVI device system and even when using the same device in different patients [24]. We have observed a very low (below 3%) frequency of arrhythmias requiring permanent pacemaker treatment after TAVI.…”

Section: Discussionmentioning

confidence: 79%

A Simplified Protocol for Transcatheter Aortic Valve Implantation that Reduces Procedure-Related Risk

Baranowski¹,

Nielsen

Ahn

2016

J Cardiovasc Dis Diagn

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Objectives: Transcatheter Aortic Valve Implantation is now a well-established procedure and continuous development has improved the technique. The object of this paper is to describe the successive steps taken at our department to improve our protocol, resulting in a more effective and patient-safe procedure.Design: An echo-guided method for aortic cusp alignment was used in 229 patients. In 139 patients predilatation was excluded from the protocol. In the last 47 of the patients we exchanged the stiff guide-wire in the left ventricle with a soft wire for valve placement.Results: There was a significant decrease in the use of contrast medium during the period with 90% of patients receiving less than 50 ml contrast and 35% no contrast at all. In more than half the patients we only used rapid pacing in association with deployment of the stent valve. We had six cases of pericardial bleeding due to penetration of the stiff guide wire through the left ventricular (LV) wall. This complication was avoided in all subsequent patients where we exchanged the stiff catheter to a soft guidewire in the ascending aorta before introduction of the wire and stent valve into the LV. Conclusions:We have successively modified our standard protocol for implantation of a balloon-expandable transcatheter aortic valve. This has simplified the procedure and reduced the risk for certain procedure-related complications.

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“…Among the electrocardiographic (ECG) criteria, right bundle branch block is the strongest predictor for pacemaker requirement (24,25). To date, some investigations have reported descriptive changes in the surface ECG after TAVI (15,(26)(27)(28)(29)(30)(31). In the published trials, the incidence of permanent pacemaker implantation after TAVI with the CoreValve system has been reported to be 20% to 42.5%, and that of a new left bundle branch block has been reported to range between 50% and 70% (5,(26)(27)(28)(29)(30)(31).…”

Section: Conduction Disordersmentioning

confidence: 99%

“…To date, some investigations have reported descriptive changes in the surface ECG after TAVI (15,(26)(27)(28)(29)(30)(31). In the published trials, the incidence of permanent pacemaker implantation after TAVI with the CoreValve system has been reported to be 20% to 42.5%, and that of a new left bundle branch block has been reported to range between 50% and 70% (5,(26)(27)(28)(29)(30)(31). Nevertheless, with the balloon-expandable shorter Edwards SAPIEN prosthesis, which is placed in the aortic annulus without direct impact on the left ventricular outflow tract, the incidence of atrioventricular conduction block requiring pacemaker has been reported between 0% and 6% and the incidence of new-onset left bundle branch block has been reported to have a rate of 3.3% (32,33).…”

Section: Conduction Disordersmentioning

confidence: 99%

ECG Abnormalities after Transcatheter Aortic Valve Implantation

Akın¹,

Nienaber²

2014

Arch Cardiovasc Imaging

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Transcatheteraortic valve implantation, first introduced in 2002, has been established as an alternative modality for patients deemed not suitable for open-heart surgery. The anatomical vicinity of the atrioventricular node and the His bundle to the non-coronary and rightcoronary aortic cusps predisposes patients to conduction abnormalities in case of severe calcification or mechanical trauma during valve implantation. However, the two evaluated valves (CoreValve and Edwards SAPIEN valve) have different rates of these complications, mainly driven by their respective geometry. Currently, there is ongoing evaluation of the true rate of conduction disorders and their clinical relevance or durability. The initial experience of fatal outcomes with conduction disorders such as complete atrioventricular block has increased the rate of subsequent pacemaker implantation up to 50%. However, prophylactic pacemaker implantation is associated with several possible complications. Thus, there is a need for further data from large-scale series taking into account the true rate of clinically relevant conduction disorders.Keywords:Heart Valve Prosthesis Implantation; Atrioventricular Block; Bundle-Branch Block; Pacemaker; Artificial; Bundle of His Implication for health policy/practice/research/medical education: The transcatheter aortic valve implantation is an established tool for the treatment of multimorbid patients suffering from severe symptomatic aortic valve stenosis. However, it is much more associated with with pacemaker dependence as compared to classic open aortic valve surgery. Within this review we try to explain the differences between the interventional procedure and the open surgical procedure as well as the difference between different vlave types.

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Risk for Permanent Pacemaker After Transcatheter Aortic Valve Implantation: A Comprehensive Analysis of the Literature

Cited by 201 publications

References 48 publications

Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world

Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world

A Simplified Protocol for Transcatheter Aortic Valve Implantation that Reduces Procedure-Related Risk

ECG Abnormalities after Transcatheter Aortic Valve Implantation

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