Universität zu Köln

Droppa, Michal, Rudolph, Tanja K., Baan, Jan, Nielsen, Niels-Erik, Baumgartner, Helmut, Vendrik, Jeroen, Froehlich, Maren, Borst, Oliver, Woehrle, Jochen, Gawaz, Meinrad, Potratz, Paul, Hack, Luis P., Mauri, Victor, Baranowski, Jacek, Bramlage, Peter, Kurucova, Jana, Thoenes, Martin, Rottbauer, Wolfgang and Geisler, Tobias (2020). Risk factors for permanent pacemaker implantation in patients receiving a balloon-expandable transcatheter aortic valve prosthesis. Heart Vessels, 35 (12). S. 1735 - 1746. NEW YORK: SPRINGER. ISSN 1615-2573

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Abstract

Permanent pacemaker implantation (PPI) is a widely recognized complication associated with TAVI (incidence up to 20%). Smaller registries have identified several variables associated with PPI. The objective was to validate patient- and transcatheter aortic valve implantation (TAVI)-related procedural variables associated with PPI. We performed a retrospective analysis of patients from six European centers undergoing TAVI with the Edwards SAPIEN 3 prosthesis. Baseline variables and pre-procedural ECG characteristics and CT-scans were taken into account. Data for 1745 patients were collected; 191 (10.9%) required PPI after TAVI. The baseline variables pulmonary hypertension (OR 1.64; 95% CI 1.01-2.59), QRS duration > 117 ms (OR 2.58; 95% CI 1.73-3.84), right bundle branch block (RBBB; OR 5.14; 95% CI 3.39-7.72), left anterior hemi block (OR 1.92; 95% CI 1.19-3.02) and first-degree atrioventricular block (AVB, OR 1.63; 95%CI 1.05-2.46) were significantly associated with PPI. RBBB (OR 8.11; 95% CI 3.19-21.86) and first-degree AVB (OR 2.39; 95% CI 1.18-4.66) remained significantly associated in a multivariate analysis. Procedure-related variables included access site (TF; OR 1.97; 95% CI 1.07-4.05), implanted valve size (29 mm; OR 1.88; 95% CI 1.35-2.59), mean TAVI valve implantation depth below the annulus > 30% (OR 3.75; 95% CI 2.01-6.98). Patients receiving PPI had longer ICU stays and later discharges. Acute kidney injury stage 2/3 was more common in patients with PPI until discharge (15.2 vs. 3.1%;p = 0.007), but was not statistically significant thereafter. Further differences in outcomes at 30 days did not reach significance. The data will aid pre- and post-procedural patient management and prevent adverse long-term outcomes. Clinical Trial: NCT03497611.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Droppa, Michal UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baan, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nielsen, Niels-Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Baumgartner, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Vendrik, Jeroen UNSPECIFIED UNSPECIFIED UNSPECIFIED Froehlich, Maren UNSPECIFIED UNSPECIFIED UNSPECIFIED Borst, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Woehrle, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawaz, Meinrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Potratz, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Hack, Luis P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Baranowski, Jacek UNSPECIFIED UNSPECIFIED UNSPECIFIED Bramlage, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurucova, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Thoenes, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rottbauer, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Geisler, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-329093
DOI:	10.1007/s00380-020-01653-6
Journal or Publication Title:	Heart Vessels
Volume:	35
Number:	12
Page Range:	S. 1735 - 1746
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1615-2573
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEART-FAILURE; PREDICTORS; IMPACT; REPLACEMENT; DYSFUNCTION; NEED Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32909