Key result
The overall incidence of permanent pacemaker implantation after conventional cardiac surgery was 4.2%, with the highest rates observed after tricuspid valve interventions (8.8%) and TAVI with CoreValve (8.0%).
Why the study?
Permanent pacemaker implantation is required in 0.4-8.5% of patients after open heart surgery, prompting evaluation of its incidence and impact on intrahospital outcomes.
Does the type of cardiac surgery or TAVI influence the incidence of postoperative permanent pacemaker implantation and hospital length of stay?
Observational (n=3,466)
No
Does the type of cardiac surgery or TAVI influence the incidence of postoperative permanent pacemaker implantation and hospital length of stay?
Permanent pacemaker implantation is a frequent complication after tricuspid valve surgery and TAVI with self-expanding valves, leading to significantly prolonged hospital stays.
PPI after tricuspid surgery or CoreValve TAVI prolongs stay; observational data leaves open targeted prevention trials.
Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4–8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its influence on intrahospital outcomes. This was a single-centre retrospective study. We reviewed all patients who underwent either open heart surgery or transcatheter aortic valve implantation (TAVI) between the years 2015 and 2017. Included were all patients with PPI postoperatively before discharge. We compared the patient demographics, and perioperative state, incidence of PPI and intrahospital stay among groups. After cardiac surgery a total of 135 (4.2%) patients received a PPI. The PPI incidence was highest in the tricuspid valve intervention group — 8.8% followed by aortic valve replacement (AVR) patients with 3.3%. After TAVI incidence of PPI was 4.0% after Sapien valve and 8% after CoreValve implantations, respectively. Incidence of PPI after TAVI with the Sapien valve was not significantly higher when compared to conventional AVR, but it was significantly higher after TAVI with CoreValve. Regardless of the initial procedure a need for PPI significantly increased the total length of hospital stay.
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Kalējs et al. (2019) conducted an observational in Patients undergoing open heart surgery or TAVI (n=3,466). Cardiac surgery (conventional open heart or TAVI) vs. Different types of cardiac surgery was evaluated on Incidence of permanent pacemaker implantation (PPI) before discharge. The overall incidence of permanent pacemaker implantation after conventional cardiac surgery was 4.2%, with the highest rates observed after tricuspid valve interventions (8.8%) and TAVI with CoreValve (8.0%).
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