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Predictors of permanent pacemaker requirement after transcatheter aortic valve implantation: insights from a Brazilian registry.

Abstract：

BACKGROUND:The aim of this study is to evaluate the predictors of permanent pacemaker (PPM) implantation after TAVI. METHODS:Between January 2008 and February 2012, 418 patients with severe aortic stenosis underwent TAVI and were enrolled in a Brazilian multicenter registry. After excluding patients who died during the procedure and those with a previous PPM, 353 patients were included in the analysis. RESULTS:At 30 days, the overall incidence of PPM implantation was 25.2%. Patients requiring PPM were more likely to be older (82.73 vs. 81.10 years, p=0.07), have pre-dilation (68.42% vs. 60.07%, p=0.15), receive CoreValve (93.68% vs. 82.55%, p=0.008), and have baseline right bundle branch block (RBBB, 25.26% vs. 6.58%, p<0.001). On multivariable analysis, CoreValve vs. Sapien XT (OR, 4.24; 95% CI, 1.56-11.49; p=0.005), baseline RBBB (OR, 4.41; 95% CI, 2.20-8.82; p<0.001), and balloon pre-dilatation (OR, 1.75; 95% CI, 1.02-3.02; p=0.04) were independent predictors of PPM implantation. CONCLUSION:PPM implantation occurred in approximately one-fourth of cases. Pre-existing RBBB, balloon pre-dilatation, and CoreValve use were independent predictors of PPM after TAVI. The type of prosthesis used and pre-balloon dilatation should be considered in TAVI candidates with baseline RBBB.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Gensas CS,Caixeta A,Siqueira D,Carvalho LA,Sarmento-Leite R,Mangione JA,Lemos PA,Colafranceschi AS,Caramori P,Ferreira MC,Abizaid A,Brito FS Jr,Brazilian Registry in Transcatheter Aortic Valve Implantation Investigators.

doi

10.1016/j.ijcard.2014.05.020

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

248-52

issue

2

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(14)01003-1

journal_volume

175

pub_type

杂志文章,多中心研究

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