What is the clinical evidence from this study?

Study design: Cohort. Population: Severe aortic stenosis (n=152). Intervention: Permanent pacemaker (PPM) implantation following TAVR with the Lotus valve. Primary outcome: Pacemaker dependency at one year.

January 4, 2018

Long‐term pacemaker dependency and impact of pacing on mortality following transcatheter aortic valve replacement with the LOTUS valve

Resultado clave

Among patients requiring a permanent pacemaker following TAVR with the Lotus valve, 38% remained pacemaker dependent at one year.

Diseño del estudio

Tipo

Cohort (n=152)

Multicéntrico

PICO estructurado

What is the rate of long-term pacemaker dependency in patients requiring permanent pacemaker implantation following TAVR with the Lotus valve?

Población

152 patients (mean age 83.6 years, 54% female) with severe aortic stenosis undergoing TAVR with the Lotus valve system, followed for 12 months.

Exposición

Permanent pacemaker (PPM) implantation post-TAVR

Resultado

Pacemaker dependency at 1, 3, 6, and 12 monthssafety

The majority of patients who require a permanent pacemaker after TAVR with the Lotus valve recover conduction over time, with only 38% remaining pacing dependent at one year.

Resumen

OBJECTIVES: valve system (Boston Scientific), and the impact of PPM implantation on long-term morbidity and mortality. BACKGROUND: Conduction abnormalities are among the most common complications following TAVR. Limited studies have assessed pacing dependency following TAVR. METHODS: Consecutive patients (n = 166) with severe aortic stenosis who underwent TAVR with the Lotus valve system were prospectively recruited from a single-center. PPMs were implanted according to standard clinical criteria. Patients were followed in-hospital and at 1, 3, 6, and 12 months to determine pacemaker dependency and clinical outcomes. RESULTS: Fourteen patients with a pre-existing PPM (8%) were excluded with the remaining 152 patients aged 83.6 ± 5.6 years and 46% male. PPMs were implanted 3.8 ± 4 days post-TAVR in 38/152 patients (25%). Indication for PPM was complete heart block in 29 (76%) of patients. At 30-day and one-year follow up, 57% and 38% of patients were pacemaker dependent, respectively. The mean ventricular pacing percentage decreased in the first three months after PPM implantation and remained relatively stable after that. CONCLUSION: Only 38% of Lotus recipients who require a PPM following TAVR with the Lotus valve remain pacing dependent at one year.

Preguntar a la IA

Me gusta

Guardar