Key result
First-year permanent pacemaker post-TAVI is linked to higher long-term mortality and no LVEF improvement.
Why the study?
Expanding indications for TAVI have highlighted complications such as new LBBB or PPM implantation, but studies on the long-term outcomes of these conduction abnormalities are limited.
Does the development of permanent pacemaker implantation or permanent LBBB after TAVI increase all-cause mortality compared to no conduction abnormalities in patients with severe aortic stenosis?
Cohort
Does the development of permanent pacemaker implantation or permanent LBBB after TAVI increase all-cause mortality compared to no conduction abnormalities in patients with severe aortic stenosis?
p-value: p=0.027
Permanent pacemaker implantation within the first year after TAVI is associated with a lack of left ventricular function improvement and significantly higher long-term mortality.
Should not yet alter post-TAVI conduction thresholds; leaves open whether PPM drives mortality or marks higher-risk patients.
Background: Expanding indications for transcatheter aortic valve implantation (TAVI) highlighted the importance of complications such as new left bundle branch block (LBBB) or permanent pacemaker (PPM) implantation. However, studies on the long-term outcomes of these conduction abnormalities (CA) are limited. This study aims to examine the progression of CA within the first year after TAVI and their long-term prognostic value. Methods: TAVI patients were divided into 1) PPM implantation within the first year, 2) post-TAVI LBBB persisting until 1 year (permanent LBBB), and 3) no-CA. Endpoint was all-cause mortality after 1 year. Results: = 0.027), as well as pre-TAVI EuroSCORE II and New York Heart Association III-IV at 1 year, were independently associated with the outcome. Conclusions: Post-TAVI CAs are dynamic within the first year. Patients who needed PPM implantation did not show significant improvement in left ventricular function after TAVI and had higher long-term mortality.
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Chua et al. (2025) conducted a cohort in Transcatheter aortic valve implantation (TAVI). Permanent pacemaker (PPM) implantation or permanent LBBB vs. No conduction abnormalities (no-CA) was evaluated on All-cause mortality after 1 year (p=0.027). Permanent pacemaker implantation within the first year after TAVI was associated with higher long-term all-cause mortality and lack of significant improvement in left ventricular function.
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