Risk Prediction Model for Cardiac Implantable Electronic Device Implantation After Transcatheter Aortic Valve Replacement.
JACC Clin Electrophysiol
; 6(3): 295-303, 2020 03.
Article
in En
| MEDLINE
| ID: mdl-32192680
ABSTRACT
OBJECTIVES:
The aim of this study was to develop and validate a risk prediction model for high-grade atrioventricular block requiring cardiac implantable electronic device (CIED) implantation after transcatheter aortic valve replacement (TAVR).BACKGROUND:
High-grade atrioventricular block requiring CIED remains a significant sequelae following TAVR. Although several pre-operative characteristics have been associated with the risk of post-operative CIED implantation, an accurate and validated risk prediction model is not established yet.METHODS:
This was a single center, retrospective study of consecutive patients who underwent TAVR from March 10, 2011, to October 8, 2018. This cohort sample was randomly divided into a derivation cohort (group A) and a validation cohort (group B). A scoring system for risk prediction of post-TAVR CIED implantation was devised using logistic regression estimates in group A and the calibration and validation were done in group B.RESULTS:
A total of 1,071 patients underwent TAVR during the study period. After excluding pre-existing CIED, a total of 888 cases were analyzed (group A 507 and group B 381). Independent predictive variables were as follows self-expanding valve (1 point), hypertension (1 point), pre-existing first-degree atrioventricular block (1 point), and right bundle branch block (2 points). The resulting score was calculated from the total points. The internal validation in group B showed an ideal linear relationship in calibration plot (R2 = 0.933) and a good predictive accuracy (area under the curve 0.693; 95% confidence interval 0.627 to 0.759).CONCLUSIONS:
This prediction model accurately predicts post-operative risk of CIED implantation with simple pre-operative parameters.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pacemaker, Artificial
/
Cardiac Pacing, Artificial
/
Atrioventricular Block
/
Transcatheter Aortic Valve Replacement
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
JACC Clin Electrophysiol
Year:
2020
Document type:
Article
Affiliation country:
Estados Unidos