Incidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves
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Incidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves. / Pagnesi, Matteo; Kim, Won-Keun; Baggio, Sara; Scotti, Andrea; Barbanti, Marco; De Marco, Federico; Adamo, Marianna; Eitan, Amnon; Estévez-Loureiro, Rodrigo; Conradi, Lenard; Toggweiler, Stefan; Mylotte, Darren; Veulemans, Verena; Søndergaard, Lars; Wolf, Alexander; Giannini, Francesco; Maffeo, Diego; Pilgrim, Thomas; Montorfano, Matteo; Zweiker, David; Ferlini, Marco; Kornowski, Ran; Hildick-Smith, David; Taramasso, Maurizio; Abizaid, Alexandre; Schofer, Joachim; Sinning, Jan-Malte; Van Mieghem, Nicolas M; Wöhrle, Jochen; Khogali, Saib; Van der Heyden, Jan A S; Wood, David A; Ielasi, Alfonso; MacCarthy, Philip; Brugaletta, Salvatore; Hamm, Christian W; Costa, Giuliano; Testa, Luca; Massussi, Mauro; Alarcón, Robert; Schäfer, Ulrich; Brunner, Stephanie; Reimers, Bernhard; Lunardi, Mattia; Zeus, Tobias; Vanhaverbeke, Maarten; Naber, Christoph K; Di Ienno, Luca; Buono, Andrea; Windecker, Stephan; Schmidt, Albrecht; Lanzillo, Giuseppe; Vaknin-Assa, Hana; Arunothayaraj, Sandeep; Saccocci, Matteo; Siqueira, Dimytri; Brinkmann, Christina; Sedaghat, Alexander; Ziviello, Francesca; Seeger, Julia; Rottbauer, Wolfgang; Brouwer, Jorn; Buysschaert, Ian; Jelisejevas, Julius; Bharucha, Apurva; Regueiro, Ander; Metra, Marco; Colombo, Antonio; Latib, Azeem; Mangieri, Antonio.
In: JACC-CARDIOVASC INTE, Vol. 16, No. 16, 28.08.2023, p. 2004-2017.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Incidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves
AU - Pagnesi, Matteo
AU - Kim, Won-Keun
AU - Baggio, Sara
AU - Scotti, Andrea
AU - Barbanti, Marco
AU - De Marco, Federico
AU - Adamo, Marianna
AU - Eitan, Amnon
AU - Estévez-Loureiro, Rodrigo
AU - Conradi, Lenard
AU - Toggweiler, Stefan
AU - Mylotte, Darren
AU - Veulemans, Verena
AU - Søndergaard, Lars
AU - Wolf, Alexander
AU - Giannini, Francesco
AU - Maffeo, Diego
AU - Pilgrim, Thomas
AU - Montorfano, Matteo
AU - Zweiker, David
AU - Ferlini, Marco
AU - Kornowski, Ran
AU - Hildick-Smith, David
AU - Taramasso, Maurizio
AU - Abizaid, Alexandre
AU - Schofer, Joachim
AU - Sinning, Jan-Malte
AU - Van Mieghem, Nicolas M
AU - Wöhrle, Jochen
AU - Khogali, Saib
AU - Van der Heyden, Jan A S
AU - Wood, David A
AU - Ielasi, Alfonso
AU - MacCarthy, Philip
AU - Brugaletta, Salvatore
AU - Hamm, Christian W
AU - Costa, Giuliano
AU - Testa, Luca
AU - Massussi, Mauro
AU - Alarcón, Robert
AU - Schäfer, Ulrich
AU - Brunner, Stephanie
AU - Reimers, Bernhard
AU - Lunardi, Mattia
AU - Zeus, Tobias
AU - Vanhaverbeke, Maarten
AU - Naber, Christoph K
AU - Di Ienno, Luca
AU - Buono, Andrea
AU - Windecker, Stephan
AU - Schmidt, Albrecht
AU - Lanzillo, Giuseppe
AU - Vaknin-Assa, Hana
AU - Arunothayaraj, Sandeep
AU - Saccocci, Matteo
AU - Siqueira, Dimytri
AU - Brinkmann, Christina
AU - Sedaghat, Alexander
AU - Ziviello, Francesca
AU - Seeger, Julia
AU - Rottbauer, Wolfgang
AU - Brouwer, Jorn
AU - Buysschaert, Ian
AU - Jelisejevas, Julius
AU - Bharucha, Apurva
AU - Regueiro, Ander
AU - Metra, Marco
AU - Colombo, Antonio
AU - Latib, Azeem
AU - Mangieri, Antonio
N1 - Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2023/8/28
Y1 - 2023/8/28
N2 - OBJECTIVES: The authors sought to evaluate the incidence, predictors, and outcomes of new permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) with contemporary self-expanding valves (SEV).BACKGROUND: Need for PPI is frequent post-TAVR, but conflicting data exist on new-generation SEV and on the prognostic impact of PPI.METHODS: This study included 3,211 patients enrolled in the multicenter NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) and NEOPRO-2 (A Multicenter Comparison of ACURATE NEO2 Versus Evolut PRO/PRO+ Transcatheter Heart Valves 2) registries (January 2012 to December 2021) who underwent transfemoral TAVR with SEV. Implanted transcatheter heart valves (THV) were Acurate neo (n = 1,090), Acurate neo2 (n = 665), Evolut PRO (n = 1,312), and Evolut PRO+ (n = 144). Incidence and predictors of new PPI and 1-year outcomes were evaluated.RESULTS: New PPI was needed in 362 patients (11.3%) within 30 days after TAVR (8.8%, 7.7%, 15.2%, and 10.4%, respectively, after Acurate neo, Acurate neo2, Evolut PRO, and Evolut PRO+). Independent predictors of new PPI were Society of Thoracic Surgeons Predicted Risk of Mortality score, baseline right bundle branch block and depth of THV implantation, both in patients treated with Acurate neo/neo2 and in those treated with Evolut PRO/PRO+. Predischarge reduction in ejection fraction (EF) was more frequent in patients requiring PPI (P = 0.014). New PPI was associated with higher 1-year mortality (16.9% vs 10.8%; adjusted HR: 1.66; 95% CI: 1.13-2.43; P = 0.010), particularly in patients with baseline EF <40% (P for interaction = 0.049).CONCLUSIONS: New PPI was frequently needed after TAVR with SEV (11.3%) and was associated with higher 1-year mortality, particularly in patients with EF <40%. Baseline right bundle branch block and depth of THV implantation independently predicted the need of PPI.
AB - OBJECTIVES: The authors sought to evaluate the incidence, predictors, and outcomes of new permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) with contemporary self-expanding valves (SEV).BACKGROUND: Need for PPI is frequent post-TAVR, but conflicting data exist on new-generation SEV and on the prognostic impact of PPI.METHODS: This study included 3,211 patients enrolled in the multicenter NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) and NEOPRO-2 (A Multicenter Comparison of ACURATE NEO2 Versus Evolut PRO/PRO+ Transcatheter Heart Valves 2) registries (January 2012 to December 2021) who underwent transfemoral TAVR with SEV. Implanted transcatheter heart valves (THV) were Acurate neo (n = 1,090), Acurate neo2 (n = 665), Evolut PRO (n = 1,312), and Evolut PRO+ (n = 144). Incidence and predictors of new PPI and 1-year outcomes were evaluated.RESULTS: New PPI was needed in 362 patients (11.3%) within 30 days after TAVR (8.8%, 7.7%, 15.2%, and 10.4%, respectively, after Acurate neo, Acurate neo2, Evolut PRO, and Evolut PRO+). Independent predictors of new PPI were Society of Thoracic Surgeons Predicted Risk of Mortality score, baseline right bundle branch block and depth of THV implantation, both in patients treated with Acurate neo/neo2 and in those treated with Evolut PRO/PRO+. Predischarge reduction in ejection fraction (EF) was more frequent in patients requiring PPI (P = 0.014). New PPI was associated with higher 1-year mortality (16.9% vs 10.8%; adjusted HR: 1.66; 95% CI: 1.13-2.43; P = 0.010), particularly in patients with baseline EF <40% (P for interaction = 0.049).CONCLUSIONS: New PPI was frequently needed after TAVR with SEV (11.3%) and was associated with higher 1-year mortality, particularly in patients with EF <40%. Baseline right bundle branch block and depth of THV implantation independently predicted the need of PPI.
KW - Humans
KW - Incidence
KW - Bundle-Branch Block
KW - Prognosis
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
KW - Pacemaker, Artificial
U2 - 10.1016/j.jcin.2023.05.020
DO - 10.1016/j.jcin.2023.05.020
M3 - SCORING: Journal article
C2 - 37480891
VL - 16
SP - 2004
EP - 2017
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 16
ER -