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Incidence and predictors of permanent pacemaker implantation after surgical aortic v alve replacement: Data of the Netherlands Heart Registration (NHR)
Author(s) -
Ravaux Justine M.,
Van Kuijk Sander MJ,
Di Mauro Michele,
Vernooy Kevin,
Bidar Elham,
Mariani Silvia,
Dato Giulia Actis,
Van′t Hof Arnoud W,
Veenstra Leo,
Kats Suzanne,
Houterman Saskia,
Maessen Jos G,
Lorusso Roberto
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15803
Subject(s) - medicine , aortic valve replacement , confidence interval , odds ratio , incidence (geometry) , cardiology , stenosis , clinical endpoint , complication , surgery , randomized controlled trial , physics , optics
Objective Permanent pacemaker implantation (PPI) after surgical aortic valve replacement (SAVR) remains a frequent complication. Predictors, however, have been mainly investigated in single‐center studies. Therefore, nationwide data were used to identify patients—and procedural risk factors for postoperative PPI. Materials and Methods Data were retrospectively collected from the Netherlands Heart Registration (NHR). Patients enrolled in the NHR undergoing isolated SAVR from 2013 to 2019 were analyzed. Primary endpoint was in‐hospital PPI during hospitalization after SAVR. Results From the NHR database, 5600 patients with symptomatic aortic valve stenosis were included in the study. Crude incidence of post‐SAVR PPI was 4.0%. Backward regression analysis identified previous cardiac surgery (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.18–2.76), extra‐corporeal circulation time (OR: 1.01; 95% CI: 1.00–1.01), vasopressor use (OR: 2.66; 95% CI: 1.79–3.96) and in‐hospital cardiac conduction abnormalities (OR: 4.48; 95% CI: 3.36–5.98) as potential predictors for PPI. Across the time, PPI after SAVR significantly increased (OR: 1.11; 95% CI: 1.03–1.21). Conclusions From this nationwide analysis, PPI after SAVR remains a low but increasingly frequent complication. Several predictive factors for postoperative PPI after SAVR have been identified and might be useful for patient informed consent about potential adverse event rate.