B-48 | Outcomes Following Pacemaker Implantation During Mitral Valve Repair and Replacement: A Meta-Analysis

Patients undergoing mitral valve interventional procedures (MVI), involving repair or replacement, are highly susceptible to developing electrophysiological disturbances due to its proximal location to the mitral valve annulus resulting in the need for a permanent pacemaker (PPM). We aimed to perform a meta-analysis comparing long-term outcomes after MVI in individuals who required a PPM compared to those who did not. We conducted a comprehensive search of multiple databases to evaluate clinical trials and observational studies that assessed outcomes in individuals who underwent mitral valve repair or replacement procedures requiring PPM compared to those who did not. A random-effects model was used to calculate risk ratios (RRs) with 95% confidence intervals. Outcomes assessed were mortality, cerebrovascular accidents (CVA), and renal failure. A total of 3 studies were included in the analysis encompassing 6546 patients undergoing MVI, of which 1037 required PPM and 5509 did not. There were no significant differences noted regarding risks of mortality (RR 0.98; 95% CI 0.47-2.06; P = 0.97), CVA (RR 1.11; 95% CI 0.92 - 1.33; P = 0.29), and renal failure (RR 1.12; 95% CI 0.70-1.82; P = 0.63) in those requiring PPM compared to those who did not. In patients undegoing mitral valve interventional procedures, permanent pacemaker implantation is associated with similar adverse outcomes compared to those not requiring PPM. Further randomized controlled trials with larger sample sizes are warranted to confirm these findings.