Impact of Right Ventricular Pacing in Patients Who Underwent Implantation of Permanent Pacemaker After Transcatheter Aortic Valve Implantation
| Autor: | Rahul Thomas, Sandeep M. Patel, Takahiro Tsushima, Judith A. Mackall, Toral R. Patel, Ankur Kalra, Guillherme F. Attizzani, Marco A. Costa, Daniel I. Simon, Jerry Lipinski, Fahd Nadeem, Sergio Thal, Jun Li, Mauricio Arruda, Petar Saric, Thomas Ladas |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pacemaker Artificial medicine.medical_specialty Transcatheter aortic Heart Ventricles 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement Electrocardiography 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Cause of Death Internal medicine medicine Humans Registries 030212 general & internal medicine Aged Ohio Retrospective Studies Aged 80 and over business.industry Incidence Hazard ratio Arrhythmias Cardiac Aortic Valve Stenosis Middle Aged Ventricular pacing Prognosis medicine.disease Confidence interval Survival Rate Heart failure Cohort Ventricular Function Right Cardiology Female Permanent pacemaker Cardiology and Cardiovascular Medicine Complication business Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 122:1712-1717 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2018.07.046 |
| Popis: | Atrioventricular conduction disturbances requiring implantation of permanent pacemaker (PPM) are a common complication following transcatheter aortic valve implantation (TAVI). Previous registry data are conflicting but suggestive of an increased risk in heart failure admissions in the post-TAVI PPM cohort. Given the expanding use of TAVI, the present study evaluates the effects of chronic right ventricular pacing (RV pacing) in post-TAVI patients. This is a single-center study of 672 patients who underwent TAVI from 2011 to 2017 of which 146 underwent PPM. Follow-up 1-year post-TAVI outcome data were available for 55 patients and were analyzed retrospectively. Patients who underwent PPM were more likely to have heart failure admissions (17.1% vs 10.1%; hazard ratio [HR] 1.70; 95% confidence interval [CI] 1.10 to 2.64; p 0.019) and a trend toward increased mortality (21.9% vs 15.4%; HR 1.42; 95% CI 0.99 to 2.05; p 0.062). At 1-year follow-up, 30 of 55 (54.5%) patients demonstrated40% RV pacing. Compared with patients who had40% RV pacing, those with40% RV pacing were more likely to have heart failure admissions (8% vs 40%; HR 5.0; 95% CI 1.23 to 20.27; p 0.007) and demonstrated a trend toward increased mortality (12% vs 33.3%; HR 2.78; 95% CI 0.86 to 9.00; p 0.064). This is suggestive that the post-TAVI PPM cohort is particularly sensitive to chronic RV pacing. |
| Databáze: | OpenAIRE |
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