Among patients requiring a permanent pacemaker after TAVI, 61.3% were pacemaker-dependent, and no clinical or imaging variables reliably predicted this long-term reliance on pacing.
Observational (n=31)
No
What is the prevalence and what are the predictors of pacemaker dependency in patients undergoing permanent pacemaker implantation after TAVI?
Pacemaker dependency is common (61.3%) among patients requiring a permanent pacemaker after TAVI, but it cannot be reliably predicted by baseline clinical, ECG, or imaging variables.
Abstract Background / Introduction High grade atrio-ventricular block remains a common conduction-related complication following transcatheter aortic valve implantation (TAVI). However, long-term pacemaker dependency (PD) among TAVI recipients who undergo permanent pacemaker (PPM) implant is variable, and regional data from Southeast Asia are scarce. Understanding PD is essential, as persistent reliance on right-ventricular pacing may predispose to pacing-induced cardiomyopathy and influence clinical follow-up. Purpose To evaluate the prevalence, temporal pattern, and potential predictors of pacemaker dependency in patients undergoing PPM implantation after TAVI. Methods This retrospective single-centre study included all TAVI procedures performed between November 2009 and June 2025 (n=232) at a national cardiac referral centre. Patients who received a PPM within 1 year of TAVI (n=31) formed the study cohort. Pacemaker dependency was assessed using device interrogation. Clinical, electrocardiographic (ECG), and procedural variables were analyzed. Continuous variables were expressed as mean ± SD or median IQR, and associations were explored using univariate statistics. Results Of 232 TAVI patients, 31 (13.4%) received PPM within 1 year. Among these, 19 patients (61.3%) were pacemaker-dependent, and 12 (38.7%) maintained intrinsic conduction. The median time to dependency assessment was 1 1–2 month. Pre-TAVI ECGs in PD patients showed sinus rhythm (42.1%) and RBBB (21.1%), while post-TAVI complete heart block dominated (73.7%). PD patients structural parameters and baseline LVEF were comparable between groups. CT-derived measurements, including annular dimensions, calcium distribution, and cusp-specific calcification, showed no significant differences between dependent and non-dependent patients. No clinical, ECG, echocardiographic, or CT variables demonstrated independent predictive value for pacemaker dependency. Conclusion Pacemaker dependency was common among patients requiring PPM after TAVI, yet no clinical, ECG, echo, or CT variables reliably predicted long-term reliance on pacing. These findings highlight the unpredictable nature of conduction recovery and the need for larger datasets to refine predictor models.Study flowchartParameters and long term outcomes
Mashood et al. (Mon,) conducted a observational in Transcatheter aortic valve implantation (TAVI) requiring permanent pacemaker (n=31). Permanent pacemaker implantation after TAVI was evaluated on Pacemaker dependency. Among patients requiring a permanent pacemaker after TAVI, 61.3% were pacemaker-dependent, and no clinical or imaging variables reliably predicted this long-term reliance on pacing.