Permanent pacemaker implantation was required in 4.1% of patients after aortic valve replacement, with female sex (OR 5.21; 95% CI 1.48-18.34) and other variables identified as significant risk factors.
Cohort (n=465)
Permanent pacemaker implantation is an uncommon complication (4.1%) after aortic valve replacement, with risk factors including female sex, annular calcification, bicuspid aorta, conduction abnormalities, hypertension, and prolonged perfusion time.
Odds Ratio: 5.21 (95% CI 1.48–18.34)
valor p: p=0.01
BACKGROUND: The aim of this study was to evaluate the frequency of requirement for permanent pacing and related risk factors after aortic valve replacement. METHODS: Among 465 patients operated between 1994 and 2004, 19(4.1%) patients with a mean age 49.9 +/- 17.2 years required the implantation of a permanent pacemaker. Eleven of them were female (57.9%). The main indication was aortic stenosis (89.5%). Severe annular calcification was documented in 78.9% of them, and the aortic valve was bicuspid in 57.9%. RESULTS: Risk factors for permanent pacing after aortic valve replacement (AVR) identified by univariate analysis were female sex, hypertension, preoperative ejection fraction, aortic stenosis, annular calcification, bicuspid aorta, presence of right bundle branch block (RBBB) or left bundle branch block (LBBB), prolonged aortic cross-clamp and perfusion times, and preoperative use of calcium channel blockers. Multivariate analysis showed that female sex (p = 0.01, OR; 5.21, 95% CI: 1.48-18.34), annular calcification (p < 0.001, OR; 0.05, 95% CI: 0.01-0.24), bicuspid aortic valve (p = 0.02, OR; 0.24, 95% CI: 0.07-0.84), presence of RBBB (p = 0.009, OR; 0.03, 95% CI: 0.003-0.44) or LBBB (p = 0.01, OR; 0.13, 95% CI: 0.02-0.69), hypertension (p = 0.03, OR; 0.22, 95%CI: 0.05-0.89), and total perfusion time (p = 0.002, OR; 1.05, 95% CI: 1.01-1.08) were associated risk factors. CONCLUSION: Irreversible atrioventricular block requiring a permanent pacemaker implantation is an uncommon complication after AVR. Risk factors are annular calcification, bicuspid aorta, female sex, presence of RBBB or LBBB, prolonged total perfusion time, and hypertension.
Erdoğan et al. (Fri,) conducted a cohort in Aortic valve replacement (n=465). Female sex, annular calcification, bicuspid aortic valve, RBBB, LBBB, hypertension, and total perfusion time vs. Absence of respective risk factors was evaluated on Requirement of permanent pacemaker implantation (OR 5.21, 95% CI 1.48-18.34, p=0.01). Permanent pacemaker implantation was required in 4.1% of patients after aortic valve replacement, with female sex (OR 5.21; 95% CI 1.48-18.34) and other variables identified as significant risk factors.