Pacemaker-Related Complications in Patients Undergoing Transcatheter Aortic Valve Implantation: A Single-Center Experience

Giuseppe Lanzillo, Antonio Mangieri, Matteo Pagnesi, Claudio Montalto, Ozan M. Demir, Alessandra Laricchia, Jonathan Curio, Gabriele Paglino, Francesco Giannini, Antonio Colombo, Matteo Montorfano, Azeem Latib

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The aim of this study was to describe the rate of complications secondary to permanent pacemaker (PPM) implantation after transcatheter aortic valve implantation (TAVI). METHODS: Patients were identified by retrospective review of a dedicated TAVI database at a single center between 2008 and 2015. Clinical and procedural data were collected to determine the incidence and severity of the main adverse events following this procedure. The overall population included 736 patients and 123 (16.7%) underwent PPM implantation. Three patients were excluded from the final analysis due to PPM implantation occurring at other institutions post discharge. The final population consisted of 120 patients (16.3%). RESULTS: Self- and mechanically expandable valves were associated with a higher risk of PPM after TAVI compared with balloon-expandable valves (23.9% vs 27.5% vs 7.6%, respectively; P<.001). Year of procedure and operator's experience did not affect the PPM-related complication rate. A high rate of major bleeding complications (n = 29; 24.1%) was observed. Major bleeding occurred more frequently in patients who received PPM implantation within the first 24 hours post TAVI than in the group of patients who required a PPM >24 hours post TAVI (38.2% vs 12.3%, respectively; P<.01). Patients who experienced a major bleeding event following PPM insertion were more frequently on triple-antithrombotic therapy (51.7% vs 9.9%; P<.001). CONCLUSIONS: PPM-related complications are common in elderly patients after TAVI, and some of these adverse events can be life threatening. Particular attention is required in the periprocedural management of these patients.

Original languageEnglish (US)
Pages (from-to)E362-E369
JournalThe Journal of invasive cardiology
Volume32
Issue number12
StatePublished - Dec 1 2020
Externally publishedYes

Keywords

  • atrioventricular block
  • bleeding
  • clinical research
  • conduction abnormalities
  • TAVI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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