title: Permanent pacemaker implantation after transapical transcatheter aortic valve implantation.
abstract: The aim of the study was to determine the incidence of permanent pacemaker implantation (PPMI) in a cohort of 358 patients undergoing transapical aortic valve implantation (TAVI) using a balloon-expandable prosthesis between April 2008 and March 2011. After excluding patients who had had a previous PPMI (n=36; 10%), the study group consisted of 322 patients. These were divided into two groups: patients who required PPMI (PPM group) and patients who did not require it (non-PPM group). Preoperative, perioperative and one-year follow-up data were collected prospectively. Twenty (6.2%) patients required PPMI. Previous implantation of an aortic prosthesis (P=non-significant), previous coronary artery bypass grafting (P=0.05) and coronary artery disease (P<0.005) were more common in the non-PPM group. On logistic regression, only patient age seemed to be correlated to PPMI (P=0.05, odds ratio 1.08; CI 0.9-1.1). There was no difference in survival rate between the groups after 30 days (PPM group 95%, non-PPM group 93.6%). Similarly, the survival rate did not differ after one year (PPM group 84%, non-PPM group 80.9%; P=0.3). The PPMI rate after transapical TAVI using a balloon-expandable prosthesis is thus low, and has no impact on early and follow-up mortality.
authors.affiliation: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ancona
authors.forename: Miralem
authors.initials: M
authors.lastname: Pasic
authors.forename: Axel
authors.initials: A
authors.lastname: Unbehaun
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D005858:Germany; D006349:Heart Valve Diseases / Q000628:therapy*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome