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August 20, 2026Catheterization and Cardiovascular Interventions

Conduction Disturbances and Permanent Pacemaker Implantation After TAVR With Self‐Expanding Devices: The CONNAVIPRO Study

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Key result

Navitor THV is linked to ~53% higher odds of 30-day PPI versus Evolut PRO+.

  • OR 1.53
  • 95% CI 1.08-2.17
  • P=0.018
  • n=880

Why the study?

Despite differing in design and hemodynamic performance, no direct comparative studies had evaluated difference rates in conduction disturbances between the self-expanding Evolut and Navitor transcatheter heart valves.

Does the Navitor transcatheter heart valve compared to the Evolut PRO+ valve affect the rate of new permanent pacemaker implantation in patients with severe aortic stenosis?

Population

880 consecutive patients with severe aortic stenosis

Comparison

Evolut PRO+ vs Navitor transcatheter heart valves

Design

International, multicenter, retrospective registry study

Follow-up

30 days

Authors

EPEnrico PolettiOOO. OlivaAHAhmad Hassan

Discussion

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Overview

Navitor associated with higher pacemaker rates than Evolut; leaves open whether design differences drive conduction outcomes.

Key Points

  • To directly compare the incidence of new permanent pacemaker implantation and post-procedural hemodynamic performance between self-expanding Evolut PRO+ and Navitor transcatheter heart valves.
  • International, multicenter, retrospective registry (CONNAVIPRO) analyzing 880 consecutive patients with severe aortic stenosis treated with Evolut PRO+ (n = 451) or Navitor (n = 429) between May 2022 and December 2024.
  • The primary endpoint was new permanent pacemaker implantation (PPI) within 30 days among pacemaker-naïve patients, evaluated using inverse probability weighting (IPW) to adjust for baseline imbalances.
  • At 30 days, new permanent pacemaker implantation was significantly more frequent with Navitor than Evolut PRO+ (23.2% vs. 17.6%; adjusted OR 1.53, 95% CI 1.08–2.17; p = 0.018).
  • Navitor was associated with a significantly lower rate of moderate or greater paravalvular leak (2.8% vs. 7.7%; p < 0.001) but slightly higher mean transprosthetic gradients (8 vs. 7 mmHg; p = 0.002).

Study Design

Type

Cohort (n=880)

Multicenter

Yes

Structured PICO

Does the Navitor transcatheter heart valve compared to the Evolut PRO+ valve affect the rate of new permanent pacemaker implantation in patients with severe aortic stenosis?

P
Population
880 consecutive patients with severe aortic stenosis treated with Evolut PRO+ or Navitor transcatheter heart valves, evaluated at 30 days.
E
Exposure
Navitor transcatheter heart valve (n=429)
C
Comparator
Evolut PRO+ transcatheter heart valve (n=451)
O
Outcome
New permanent pacemaker implantation (PPI) within 30 days among pacemaker-naïve patientssafety

Main Result

Odds Ratio: 1.53 (95% CI 1.08–2.17)

Absolute Event Rate: 23.2% vs 17.6%

p-value: p=0.018

In patients undergoing TAVR for severe aortic stenosis, the Navitor valve was associated with a higher 30-day rate of new permanent pacemaker implantation but less moderate or greater paravalvular leak compared to the Evolut PRO+ valve.

Limitations

  • Retrospective design; associations should be interpreted as hypothesis-generating and warrant confirmation in prospective studies.
  • Retrospective design
  • Findings are hypothesis-generating and warrant confirmation in prospective studies

Cite This Study

Poletti et al. (2026) conducted a cohort in Severe aortic stenosis (n=880). Navitor THV vs. Evolut PRO+ THV was evaluated on New permanent pacemaker implantation (PPI) within 30 days among pacemaker-naïve patients (OR 1.53, 95% CI 1.08-2.17, p=0.018). Navitor THV was associated with a higher 30-day rate of new permanent pacemaker implantation compared to Evolut PRO+ (23.2% vs. 17.6%; OR 1.53, 95% CI 1.08-2.17; p=0.018).

synapsesocial.com/papers/6a86b5ff8a91293e6a1cd948https://doi.org/10.1002/ccd.70827
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pacemaker Implantation Rates With the Self‐Expandable Navitor Valve2026 · 3 citations
  2. 2A Comparison of Short-Term Clinical Outcomes Between the Navitor and Evolut Transcatheter Aortic Valve Prostheses2025 · 6 citations
  3. 3Procedural and Hemodynamic Outcomes of Contemporary Self-Expanding Valves for Transcatheter Aortic Valve Replacement: A Multicenter Comparison from the AMTRAC registry2026
  4. 4Efficacy and Safety of Navitor Versus Sapien Valves in Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis2026
  5. 5Early safety and efficacy of intra-annular versus supra-annular self-expanding transcatheter heart valves2026