title: Predictors of Permanent Pacemaker Insertion Following Transcatheter Aortic Valve Replacement With the CoreValve Revalving System Based on Computed Tomography Analysis: An Asian Multicenter Registry Study.
abstract: BACKGROUND
  To determine predictive variables for permanent pacemaker (PPM) insertion after transcatheter aortic valve replacement (TAVR) with the CoreValve Revalving System (CRS).
  
  
  RESULTS
  A total of 121 patients with severe aortic stenosis (AS) were recruited from six Asian medical centers between March 2010 and May 2013. Four patients with preexisting PPM were excluded. The mean age of the remaining 117 patients was 81.2 ± 5.1 years. Twenty-three patients (19.7%) required post-TAVR PPM, with a median time-to-insertion of 7 days (interquartile range, 5-13 days). Two variables were identified as independent predictors of PPM: (1) device depth from the non-coronary cusp (NCC) (odds ratio [OR], 1.263; P=.02) determined by aortic root angiography; and (2) the perimeter stretching index (OR, 1.584; P<.001) determined by computed tomography. The predictive cut-off values were as follows: a perimeter stretching index >1.13 (P<.001) and a device depth from the NCC >7.8 mm (P<.001). The diagnostic accuracy of these variables was 93.2% and 71%, respectively.
  
  
  CONCLUSIONS
  Depth of the device from the NCC and the perimeter stretching index are independent predictors of PPM insertion after CRS-TAVR.
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Cardiac Center, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736 Korea. sjpark@amc.seoul.kr.
authors.forename: Won-Jang
authors.initials: WJ
authors.lastname: Kim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Dy
authors.forename: Fabio Enrique B
authors.initials: FE
authors.lastname: Posas
authors.forename: Michael Kang-Yin
authors.initials: MK
authors.lastname: Lee
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002681:China / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods*; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*