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OBJECTIVES The aim of this study was to compare the incidence of permanent pacemaker (PPM) implantation after aortic valve replacement by rapid-deployment bioprosthesis (RDB) and standard valve (Standard). METHODS All patients undergoing aortic valve replacement between 2015 and 2018, in 1 centre, were included. A multivariate analysis on the whole cohort and then a propensity score matching were used to compare the 2 groups. The primary end point was PPM implantation. RESULTS We studied 924 patients (256 RDBs and 668 Standards). Overall, 67 PPM were implanted, 37 (14.5%) in the RDB group and 26 (3.9%) in the Standard group (P &amp;lt; 0.0001, univariate analysis). The multivariate analysis in the unmatched population found 4 independent factors associated with PPM implantation: right bundle branch block with odds ratios (ORs 3.7, 95% CI 2.9–6.7; P &amp;lt; 0.0001), RDB (OR 3.6, 95% CI 2.0–6.2; P &amp;lt; 0.0001), age (OR 1.1, 95% CI 1.0–1.1; P &amp;lt; 0.006) and endocarditis (OR 3.4, 95% CI 1.0–11.0; P &amp;lt; 0.04). In the propensity score-matched RDB group (203 patients per group), 25 patients required PPM implantation versus 3 in the Standard group (12.3% vs 1.5%, P &amp;lt; 0.0001). RDBs also had more postoperative left bundle branch block and new onset of atrial fibrillation (30.2% vs 5.1%, P &amp;lt; 0.0001 and 34.0% vs 24.1%, P = 0.029). RDBs had lower operating times (in min): aortic cross-clamping = 62 (44–76.5) vs 72 (57.5–91.5) and cardiopulmonary bypass = 81 (63–98.5) vs 91 (75–112), P &amp;lt; 0.0001. There was no significant difference in other outcomes. CONCLUSIONS RDBs were associated with reduced operating times, increased risk of atrial fibrillation and PPM implantation as compared with standard aortic valves.

Pacemaker implantation after aortic valve replacement: rapid-deployment Intuity® compared to conventional bioprostheses