Key result
Transcatheter aortic valve replacement was associated with a 26.3% overall incidence of new permanent pacemaker implantation at 1 year (RR 115.16).
Why the study?
Overall rates of permanent pacemaker implantation after TAVR vary and relate to multiple factors, prompting evaluation of 1-year incidence irrespective of valve brand, vascular access, or deployment mechanism.
Meta-Analysis (n=25,967)
Relative Risk: 115.16 (95% CI 29.8–415.1)
p-value: p=0.00001
Approximately one quarter of patients undergoing TAVR require a new permanent pacemaker implantation at 1 year post-procedure.
TAVR patients warrant proactive conduction monitoring and shared decision-making on pacemaker risk; confirms markedly elevated rates in aggregated evidence.
BackgroundPermanent pacemaker (PPM) implantation remain a common finding after Transcatheter aortic valve replacement (TAVR). Overall rate of PPM implantation after TAVR varies and is related to various factors and is highly variable. The purpose of this review is to evaluate the incidence of new permanent pacemaker implant at 1 year irrespective of valve brand manufacturer, vascular access used, deployment technique/mechanism. Secondary outcomes included all-cause mortality, 30-day, 1-year mortality, and cardiovascular mortality.MethodsWe performed a systematic search for studies that reported the incidence of PPM implantation after TAVR. Data on study, patient, and procedural characteristics were abstracted. Risk ratios (RRs); odds ratio (OR) and 95% confidence intervals were calculated by use of random effects models.Results14 studies were included, totalling 25,967 TAVR patients, mean age 80.15 ± 6.91years, 52.9% being male, 26.3% of which required PPM implantation 1-year after intervention (p = 0.00001; RR 115.16).ConclusionsVarious factors impact the risk for pacemaker implantation after TAVR and one quoter of the patients undergo new permanent pacemaker implant at 1-year post undergoing TAVR.
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Ferreira et al. (2021) conducted a meta-analysis in Severe aortic stenosis (n=25,967). Transcatheter aortic valve replacement (TAVR) was evaluated on New permanent pacemaker implantation at 1 year (RR 115.16, 95% CI 29.80-415.10, p=0.00001). Transcatheter aortic valve replacement was associated with a 26.3% overall incidence of new permanent pacemaker implantation at 1 year (RR 115.16).
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