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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.
Afiliação
  • Pagnesi M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Kim WK; Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany.
  • Baggio S; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
  • Scotti A; Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
  • Barbanti M; Università degli Studi di Enna "Kore," Enna, Italy.
  • De Marco F; Centro Cardiologico Monzino IRCCS, Milan, Italy.
  • Adamo M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Eitan A; Department of Cardiology, Carmel Medical Center, Haifa, Israel.
  • Estévez-Loureiro R; Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain.
  • Conradi L; Department of Cardiovascular Surgery, University Heart and Vascular Center, Hamburg, Germany.
  • Toggweiler S; Heart Center Lucerne, Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.
  • Mylotte D; Department of Cardiology, Galway University Hospitals, Galway, Ireland.
  • Veulemans V; Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Düsseldorf, Germany.
  • Søndergaard L; The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Wolf A; Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany.
  • Giannini F; Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy.
  • Maffeo D; Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy.
  • Pilgrim T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Montorfano M; Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
  • Zweiker D; Division of Cardiology, Medical University of Graz, Graz, Austria.
  • Ferlini M; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Kornowski R; Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
  • Hildick-Smith D; Department of Cardiology, Royal Sussex County Hospital, Brighton, United Kingdom.
  • Taramasso M; Heart Valve Clinic, University Hospital of Zürich, Zürich, Switzerland.
  • Abizaid A; Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
  • Schofer J; Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center, Hamburg, Germany; MVZ Department Structural Heart Disease, Asklepios St. Georg Clinic, Hamburg, Germany.
  • Sinning JM; Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Bonn, Germany.
  • Van Mieghem NM; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Wöhrle J; Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany.
  • Khogali S; Heart and Lung Centre, New Cross Hospital, Wolverhampton, United Kingdom.
  • Van der Heyden JAS; Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands; Interventional Cardiology Unit, AZ Sint-Jan Hospital, Bruges, Belgium.
  • Wood DA; Centre for Heart Valve and Cardiovascular Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
  • Ielasi A; Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy.
  • MacCarthy P; Department of Cardiology, King's College Hospital, London, United Kingdom.
  • Brugaletta S; Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
  • Hamm CW; Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany.
  • Costa G; Department of Cardiology, C.A.S.T. Policlinico G. Rodolico, Catania, Italy.
  • Testa L; Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy.
  • Massussi M; Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Alarcón R; Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain.
  • Schäfer U; Department of Internal Medicine, Marienkrankenhaus, Hamburg, Germany.
  • Brunner S; Heart Center Lucerne, Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.
  • Reimers B; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
  • Lunardi M; Department of Cardiology, Galway University Hospitals, Galway, Ireland.
  • Zeus T; Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Düsseldorf, Germany.
  • Vanhaverbeke M; The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Naber CK; Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany.
  • Di Ienno L; Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy.
  • Buono A; Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy.
  • Windecker S; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
JACC Cardiovasc Interv ; 16(16): 2004-2017, 2023 08 28.
Article em En | MEDLINE | ID: mdl-37480891
ABSTRACT

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Substituição da Valva Aórtica Transcateter Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Substituição da Valva Aórtica Transcateter Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article