title: Incidence and predictors of permanent pacemaker implantation following transcatheter aortic valve implantation: analysis from the German transcatheter aortic valve interventions registry.
abstract: OBJECTIVE
  To determine predictors of permanent pacemaker (PPM) implantation up to 30 days after transcatheter aortic valve implantation (TAVI) in a prospective multicenter registry.
  
  
  BACKGROUND
  Conduction disorders requiring PPM implantation are one of the most common complications seen after TAVI. Knowledge about possible predictors may help to decrease the rate of PPM implantations.
  
  
  METHODS
  In total, 1347 consecutive patients who underwent TAVI in 22 centers were prospectively enrolled in the German transcatheter aortic valve interventions registry. Both Medtronic CoreValve™ and Edwards Sapien™ valves were implanted. Patients with preprocedurally implanted PPM or implantable cardioverter defibrillator were excluded from the analysis (n = 199). Regression analysis of baseline and procedure characteristics of the remaining 1,147 patients was performed.
  
  
  RESULTS
  Procedural success was achieved in 97.4% of the cases. The rate for PPM after TAVI was 33.7%. The absence of prior valve surgery, the use of Medtronic CoreValve™ prosthesis and the presence of a porcelain aorta were identified as independent predictors for PPM after TAVI. Mortality at 30 days did not differ between patients with or without PPM necessity (6.0% vs. 8.1%, respectively; HR 0.72; CI (0.45-1.16); P = 0.17).
  
  
  CONCLUSIONS
  PPM is a common postprocedure requirement after TAVI. The absence of prior valve surgery, the implantation of Medtronic CoreValve™ prosthesis, and the presence of a porcelain aorta were independently associated with PPM after TAVI.
authors.affiliation: CardioVascular Center Frankfurt, Frankfurt, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Ledwoch
authors.forename: Jennifer
authors.initials: J
authors.lastname: Franke
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gerckens
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.forename: Jürgen
authors.initials: J
authors.lastname: Krülls-Münch
authors.forename: Matthias
authors.initials: M
authors.lastname: Vöhringer
authors.forename: Rainer
authors.initials: R
authors.lastname: Hambrecht
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Martin
authors.initials: M
authors.lastname: Horack
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: incidence; permanent pacemaker implantation; predictors; transcatheter aortic valve implantation