Pacing Using Cardiac Implantable Electric Device During TAVR: 10-Year Experience of a High-Volume Center.
JACC Cardiovasc Interv
; 17(8): 1020-1028, 2024 Apr 22.
Article
en En
| MEDLINE
| ID: mdl-38658116
ABSTRACT
BACKGROUND:
Transcatheter aortic valve replacement (TAVR) is an effective and safe therapy for severe aortic stenosis. Rapid or fast pacing is required for implantation, which can be performed via a pre-existing cardiac implantable electric device (CIED). However, safety data on CIEDs for pacing in TAVR are missing.OBJECTIVES:
The aim of this study was to elucidate procedural safety and feasibility of internal pacing with a CIED in TAVR.METHODS:
Patients undergoing TAVR with a CIED were included in this analysis. Baseline characteristics, procedural details, and complications according to Valve Academic Research Consortium 3 (VARC-3) criteria after TAVR were compared between both groups.RESULTS:
A total of 486 patients were included. Pacing was performed using a CIED in 150 patients and a transient pacemaker in 336 patients. No differences in technical success according to VARC-3 criteria or procedure duration occurred between the groups. The usage of transient pacers for pacing was associated with a significantly higher bleeding rate (bleeding type ≥2 according to VARC-3-criteria; 2.0% vs 13.1%; P < 0.01). Furthermore, impairment of the CIED appeared in 2.3% of patients after TAVR only in the group in which pacing was performed by a transient pacer, leading to surgical revision of the CIED in 1.3% of all patients when transient pacemakers were used.CONCLUSIONS:
Internal pacing using a CIED is safe and feasible without differences of procedural time and technical success and might reduce bleeding rates. Furthermore, pacing using a CIED circumvents the risk of lead dislocation. Our data provide an urgent call for the use of a CIED for pacing during a TAVR procedure in general.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
/
Estenosis de la Válvula Aórtica
/
Marcapaso Artificial
/
Estimulación Cardíaca Artificial
/
Estudios de Factibilidad
/
Hospitales de Alto Volumen
/
Reemplazo de la Válvula Aórtica Transcatéter
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
JACC Cardiovasc Interv
/
JACC cardiovasc. interv
/
JACC. cardiovascular interventions (Print)
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article