Premium
Characteristics of and current practice patterns of pacing for high‐degree atrioventricular block after transcatheter aortic valve implantation in comparison to surgical aortic valve replacement
Author(s) -
Misumida Naoki,
Pagath Mariah,
Ogunbayo Gbolahan O.,
Wilson Ryan E.,
Kim Sun Moon,
AbdelLatif Ahmed,
Elayi Claude S.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27915
Subject(s) - medicine , interquartile range , aortic valve replacement , cardiology , atrioventricular block , permanent pacemaker , confidence interval , odds ratio , surgery , stenosis
Objective We aimed to investigate the current practice patterns of permanent pacing, especially the timing of implantation, for high‐degree AV block (HDAVB) following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Background Comparative data regarding current practice patterns of permanent pacing for HDAVB between TAVI and SAVR is limited. Methods Using the National Inpatient Sample database, we identified patients who underwent TAVI or SAVR between 2012 and 2014. The incidence of HDAVB, the rate of permanent pacemaker implantation, and the timing of implantations were compared between TAVI and SAVR groups. Results We identified 33 690 and 202 110 patients who underwent TAVI and SAVR, respectively. HDAVB occurred in 3480 patients (10.3%) in the TAVI group and 11 405 patients (5.6%) in the SAVR group ( P < 0.001). Among the patients who developed HDAVB, patients in the TAVI group were more likely to undergo permanent pacemaker implantation than those in the SAVR group (74.1% vs 64.7%; P < 0.001). The median interval from TAVI to pacemaker implantation was 2 days (interquartile range 1‐3 days) vs 5 days (interquartile range 3‐7 days) from SAVR to pacemaker implantation ( P < 0.001). Among the patients who developed HDAVB, TAVI was associated with higher rates of permanent pacemaker implantation after adjusting for other comorbidities (odds ratio 1.41:95% confidence interval 1.13‐1.77; P = 0.003). Conclusions HDAVB occurred more commonly after TAVI compared to SAVR. HDAVB after TAVI compared to SAVR was associated with a higher rate of permanent pacemaker implantation at an earlier timing from the index procedure.