title: Pacemaker dependency after transcatheter aortic valve implantation with the self-expanding Medtronic CoreValve System.
abstract: OBJECTIVE
  To determine pacemaker (PM) dependency at follow-up visit in patients who underwent new permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  Single center prospective observational study including 167 patients without previous PM implantation who underwent TAVI with the self-expanding Medtronic CoreValve System (MCS) between November 2005 and February 2011. PM dependency was defined by the presence of a high degree atrioventricular block (HDAVB; second [AV2] and third degree [AV3B]), or a slow (<30 bpm) or absent ventricular escape rhythm during follow-up PM interrogation.
  
  
  RESULTS
  A total of 36 patients (21.6%) received a new PM following TAVI. The indication for PM was AV2B (n=2, 5.6%), AV3B (n=28, 77.8%), postoperative symptomatic bradycardia (n=3, 8.3%), brady-tachy syndrome (n=1, 2.8%), atrial fibrilation with slow response (n=1, 2.8%) and left bundle branch block (n=1, 2.8%). Long term follow-up was complete for all patients and ranged from 1 to 40 months (median (IQR): 11.5 (5.0-18.0 months). Of those patients with a HDAVB, 16 out of the 30 patients (53.3%) were PM independent at follow-up visit (complete or partial resolution of the AV conduction abnormality). Overall, 20 out of the 36 patients (55.6%) who received a new PM following TAVI were PM independent at follow-up.
  
  
  CONCLUSIONS
  Partial and even complete resolution of peri-operative AV conduction abnormalities after MCS valve implantation occurred in more than half of the patients.
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Robert M A
authors.initials: RM
authors.lastname: van der Boon
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Van Mieghem
authors.forename: Dominic A
authors.initials: DA
authors.lastname: Theuns
authors.forename: Rutger-Jan
authors.initials: RJ
authors.lastname: Nuis
authors.forename: Sjoerd T
authors.initials: ST
authors.lastname: Nauta
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Luc
authors.initials: L
authors.lastname: Jordaens
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Peter P T
authors.initials: PP
authors.lastname: de Jaegere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000639:trends*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000639:trends*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: AV; AV2B; AV3B; Dependency; Follow-up; HDAVB; LBBB; MCS; Medtronic CoreValve System; PM; PPI; Permanent pacemaker implantation; TAVI; Transcatheter aortic valve implantation; atrioventricular; high degree atrioventricular block (AV2B or AV3B); left bundle branch block; pacemaker; permanent pacemaker implantation; second degree atrioventricular block Mobitz II; third degree atrioventricular block; transcatheter aortic valve implantation