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Early and late pace‐maker implantation after transcatheter and surgical aortic valve replacement
Author(s) -
Biancari Fausto,
Pykäri Jouni,
Savontaus Mikko,
Laine Mika,
Husso Annastiina,
Virtanen Marko,
Maaranen Pasi,
Niemelä Matti,
Mäkikallio Timo,
Tauriainen Tuomas,
Eskola Markku,
Raivio Peter,
Valtola Antti,
Juvonen Tatu,
Airaksinen Juhani
Publication year - 2021
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.29177
Subject(s) - medicine , aortic valve replacement , prosthesis , cardiac resynchronization therapy , valve replacement , surgery , cardiology , aortic valve , implant , ejection fraction , heart failure , stenosis
Background Conduction defects requiring permanent pacemaker (PPM) implantation are frequent complications occurring after surgical (SAVR) and transcatheter aortic valve replacement (TAVR). Methods Patients who underwent TAVR or SAVR with a bioprosthesis from the nationwide FinnValve registry were the subjects of this study. Patients with prior PPM, who received a sutureless prosthesis, or required cardiac resynchronization therapy or implantable cardioverter defibrillator were excluded from this analysis. Results Four thousand and ten patients underwent SAVR and 1,897 underwent TAVR. TAVR had an increased risk of PPM implantation at 30‐day (10.1% vs. 3.5%, unadjusted OR 3.11, 95%CI 2.56–3.87) and 5‐year (15.7% vs. 8.6%, unadjusted SHR, 2.12, 95%CI 1.81–2.48) compared to SAVR. PPM implantation within 30 days from the index procedure did not increase the risk of 5‐year mortality after either SAVR or TAVR. Among 1,042 propensity score matched pairs, TAVR had an increased risk of PPM implantation at 30‐day (9.9% vs. 4.7%, p < .0001) and 5‐year (14.7% vs. 11.4%, p = .001), but late (>30 days) PPM implantation at 5‐year (4.7% vs. 6.9% SHR 0.72, 95%CI 0.47–1.10) was comparable to SAVR. The types of prosthesis had an impact on 30‐day PPM implantation after TAVR, but not on late (>30 days) PPM implantation. Conclusions Although the risk of 30‐day PPM implantation is higher after TAVR compared to SAVR, late (>30 days) PPM implantation was comparable with these treatment methods. PPM implantation within 30 days did not affect late survival.