Incidence, predictors and clinical impact of permanent pacemaker insertion in women following transcatheter aortic valve implantation: Insights from a prospective multinational registry
| Autor: | Nicolas Dumonteil, Usman Baber, Julinda Mehilli, Mauro Chiarito, Jaya Chandrasekhar, Ridhima Goel, Samin K. Sharma, Sabato Sorrentino, Emanuele Meliga, Patrizia Presbitero, Johny Nicolas, George Dangas, Paul Guedeney, Bimmer E. Claessen, Daniela Trabattoni, Anna Sonia Petronio, Didier Tchetche, Rishi Chandiramani, Roxana Mehran, Christoph Naber, Davide Cao, Peter C. Kievit, Ghada W. Mikhail, Gennaro Sardella, Nicolas M. Van Mieghem, Alessandro Iadanza, Piera Capranzano, Maria-Cruz Ferrer-Gracia, Siyan Chen, Thierry Lefèvre, Marie-Claude Morice, Alaide Chieffo, Chiara Fraccaro, Anastasios Roumeliotis, Samantha Sartori |
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| Přispěvatelé: | Cardiology |
| Rok vydání: | 2021 |
| Předmět: |
Pacemaker
Artificial medicine.medical_specialty Transcatheter aortic medicine.medical_treatment TAVR 030204 cardiovascular system & hematology Logistic regression Lower risk Prosthesis TAVI Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Risk Factors Internal medicine gender medicine Humans Radiology Nuclear Medicine and imaging Registries 030212 general & internal medicine business.industry Incidence Incidence (epidemiology) pacemaker Aortic Valve Female Treatment Outcome Aortic Valve Stenosis General Medicine Right bundle branch block medicine.disease Permanent pacemaker insertion Artificial Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and Cardiovascular Interventions, 98(6), E908-E917. Wiley-Liss Inc. Zaguán. Repositorio Digital de la Universidad de Zaragoza instname Catheterization and cardiovascular interventions, 98(6), E908-E917. Wiley-Liss Inc. |
| ISSN: | 1522-726X 1522-1946 |
| DOI: | 10.1002/ccd.29807 |
| Popis: | Objectives: To describe the incidence, predictors, and clinical impact of permanent pacemaker insertion (PPI) following transcatheter aortic valve replacement (TAVR) in women. Background: Data on pacemaker insertion complicating TAVR in women are scarce. Methods: The Women's International Transcatheter Aortic Valve implantation (WIN-TAVI) is a prospective registry evaluating the safety and efficacy of TAVR in women. We included patients without preprocedural pacemakers and divided them into two groups: (1) PPI and (2) no-PPI. We identified PPI predictors using logistic regression and studied its clinical impact on the Valve Academic Research Consortium (VARC)-2 efficacy and safety endpoints. Results: Out of 1019 patients, 922 were included in the analysis. Post-TAVR PPI occurred in 132 (14.3%) patients. Clinical and procedural characteristics were similar in both groups. Pre-existing right bundle branch block (RBBB) was associated with a high risk of post-TAVR PPI (OR 3.62, 95% CI 1.85–7.06, p < 0.001), while implantation of balloon-expandable prosthesis was associated with a lower risk (OR 0.47, 95% CI 0.30–0.74, p < 0.001). Post-TAVR PPI prolonged in-hospital stay by a median of 2 days (11 [9–16] days in PPI vs. 9 [7–14] days in no-PPI, p = 0.005), yet risks of VARC-2 efficacy and safety endpoints at 1 year were similar in both groups (adjHR 0.95, 95% CI 0.60–1.52, p = 0.84 and adjHR 1.22, 95% CI 0.83–1.79, p = 0.31, respectively). Conclusion: Pacemaker implantation following TAVR is frequent among women and is associated with pre-existing RBBB and valve type. PPI prolongs hospital stay, albeit without any significant impact on 1-year outcomes. |
| Databáze: | OpenAIRE |
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