Alperi, Alberto, Rodes-Cabau, Josep, Simonato, Matheus, Tchetche, Didier, Charbonnier, Gaetan, Ribeiro, Henrique B., Latib, Azeem, Montorfano, Matteo, Barbanti, Marco, Bleiziffer, Sabine, Redfors, Bjorn, Abdel-Wahab, Mohamed, Allali, Abdelhakim, Bruschi, Giuseppe, Napodano, Massimo, Agrifoglio, Marco, Petronio, Anna Sonia, Giannini, Cristina, Chan, Albert, Kornowski, Ran, Pravda, Nili Schamroth, Adam, Matti, Iadanza, Alessandro ORCID: 0000-0002-6435-1155, Noble, Stephane, Chatfield, Andrew, Erlebach, Magdalena, Kempfert, Joerg, Ubben, Timm, Wijeysundera, Harindra, Seiffert, Moritz, Pilgrim, Thomas ORCID: 0000-0001-8721-4068, Kim, Won-Keun ORCID: 0000-0002-0799-7478, Testa, Luca, Hildick-Smith, David, Nerla, Roberto, Fiorina, Claudia, Brinkmann, Christina, Conzelmann, Lars, Champagnac, Didier, Saia, Francesco, Nissen, Henrik, Amrane, Hafid, Whisenant, Brian, Shamekhi, Jasmin, Sondergaard, Lars, Webb, John G. and Dvir, Danny (2021). Permanent Pacemaker Implantation Following Valve-in-Valve Transcatheter Aortic Valve Replacement. J. Am. Coll. Cardiol., 77 (18). S. 2263 - 2274. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1558-3597

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Abstract

BACKGROUND Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs). OBJECTIVES The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures. METHODS Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. All THVs except CoreValve, Cribier-Edwards, Sapien, and Sapien XT were considered to be new-generation THVs. RESULTS A total of 1,987 patients without prior PPI undergoing ViV-TAVR from 2007 to 2020 were included. Of these, 128 patients (6.4%) had PPI after TAVR, with a significant decrease in the incidence of PPI with the use of new-generation THVs (4.7% vs. 7.4%; p = 0.017), mainly related to a reduced PPI rate with the Evolut R/Pro versus CoreValve (3.7% vs. 9.0%; p = 0.002). There were no significant differences in PPI rates between newer-generation balloon-and self expanding THVs (6.1% vs. 3.9%; p = 0.18). In the multivariable analysis, older age (odds ratio [OR]: 1.05 for each increase of 1 year; 95% confidence interval [CI]: 1.02 to 1.07; p = 0.001), larger THV size (OR: 1.10; 95% CI: 1.01 to 1.20; p = 0.02), and previous right bundle branch block (OR: 2.04; 95% CI: 1.00 to 4.17; p = 0.05) were associated with an increased risk of PPI. There were no differences in 30-day mortality between the PPI (4.7%) and no-PPI (2.7%) groups (p = 0.19), but PPI patients exhibited a trend toward higher mortality risk at follow-up (hazard ratio: 1.39; 95% CI: 1.02 to 1.91; p = 0.04; p = 0.08 after adjusting for age differences between groups). CONCLUSIONS In a contemporary large series of ViV-TAVR patients, the rate of periprocedural PPI was relatively low, and its incidence decreased with the use of new-generation THV systems. PPI following ViV-TAVR was associated with a trend toward increased mortality at follow-up. (J Am Coll Cardiol 2021;77:2263-73) (c) 2021 by the American College of Cardiology Foundation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Alperi, AlbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rodes-Cabau, JosepUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Simonato, MatheusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tchetche, DidierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Charbonnier, GaetanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ribeiro, Henrique B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Latib, AzeemUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montorfano, MatteoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbanti, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bleiziffer, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Redfors, BjornUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abdel-Wahab, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Allali, AbdelhakimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruschi, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Napodano, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Agrifoglio, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petronio, Anna SoniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giannini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chan, AlbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kornowski, RanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pravda, Nili SchamrothUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adam, MattiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Iadanza, AlessandroUNSPECIFIEDorcid.org/0000-0002-6435-1155UNSPECIFIED
Noble, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chatfield, AndrewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Erlebach, MagdalenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kempfert, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ubben, TimmUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wijeysundera, HarindraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seiffert, MoritzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pilgrim, ThomasUNSPECIFIEDorcid.org/0000-0001-8721-4068UNSPECIFIED
Kim, Won-KeunUNSPECIFIEDorcid.org/0000-0002-0799-7478UNSPECIFIED
Testa, LucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hildick-Smith, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nerla, RobertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiorina, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brinkmann, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Conzelmann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Champagnac, DidierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saia, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nissen, HenrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amrane, HafidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Whisenant, BrianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shamekhi, JasminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sondergaard, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Webb, John G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dvir, DannyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-608041
DOI: 10.1016/j.jacc.2021.03.228
Journal or Publication Title: J. Am. Coll. Cardiol.
Volume: 77
Number: 18
Page Range: S. 2263 - 2274
Date: 2021
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1558-3597
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SELF-EXPANDABLE VALVES; CONDUCTION DISTURBANCES; CLINICAL-OUTCOMES; RISK; PREDICTORS; BIOPROSTHESIS; STENOSIS; IMPACT; DEPTHMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60804

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