Outcomes Of Transcatheter Aortic Valve Implantation With First Degree Heart Block

Introduction: Pacemaker implantation remains a frequent complication in patients undergoing transcatheter aortic valve implantation (TAVI). Outcomes of TAVI with a baseline first degree heart block (HB) remain unknown. Methods: The purpose of this study was to evaluate outcomes of TAVI in patients with a baseline first degree HB. We utilized the National Inpatient Sample (NIS) data from the year 2011 to 2018. Results: A total of 215,938 weighted hospitalizations for TAVI were included in the analysis. Of the patient undergoing the procedure, 11000 had baseline first degree HB (5.1%) and 204938 (94.9%) patients did not have first degree HB. Patients with first degree HB had higher rates of PPM implantation (17.1% vs. 10.1%, p<0.01). At baseline, age greater than 75 (Odds Ratio [OR], 1.26[confidence interval (CI), 1.10-1.45]), male gender (OR, 1.22[CI, 1.09-1.37]), atrial fibrillation (OR, 2.01[CI, 1.68-2.4]), hypertension (OR, 1.54[CI, 1.27-1.88]) and chronic kidney disease (OR, 1.22[CI, 1.08-1.37]) were significant predictors of PPM implantation in patients undergoing TAVI with a baseline first degree HB. In terms of resource utilization, patients with baseline first degree HB had higher median cost of stay ($ 48083 vs. $ 47081) Conclusions: In conclusion we report that PPM implantation rate is higher in patients with first degree HB and that age greater than 75, male sex, hypertension and chronic kidney disease are significant predictors of this adverse event.