Journal article
Incidence, Predictors, and Outcomes of Permanent Pacemaker Implantation Following Transcatheter Aortic Analysis From the US Society of Thoracic Surgeons/American College of Cardiology TVT Registry
JACC. Cardiovascular interventions, v 9(21), pp 2189-2199
14 Nov 2016
PMID: 27832844
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVES The purpose of this study was to evaluate the incidence, predictors, and clinical outcomes of permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR).
BACKGROUND Conduction abnormalities leading to PPM implantation are common complications following TAVR. Whether PPM placement can be predicted or is associated with adverse outcomes is unclear.
METHODS A retrospective cohort study of patients undergoing TAVR in the United States at 229 sites between November 2011 and September 2014 was performed using the Society of Thoracic Surgeons/American College of Cardiology TVT Registry and the Centers for Medicare and Medicaid Services database.
RESULTS PPM placement was required within 30 days of TAVR in 651 of 9,785 patients (6.7%) and varied among those receiving self-expanding valves (25.1%) versus balloon-expanding valves (4.3%). Positive predictors of PPM implantation were age (per 5-year increment, odds ratio: 1.07; 95% confidence interval [CI]: 1.01 to 1.15), prior conduction defect (odds ratio: 1.93; 95% CI: 1.63 to 2.29), and use of self-expanding valve (odds ratio: 7.56; 95% CI: 5.98 to 9.56). PPM implantation was associated with longer median hospital stay (7 days vs. 6 days; p < 0.001) and intensive care unit stay (56.7 h vs. 45.0 h; p < 0.001). PPM implantation was also associated with increased mortality (24.1% vs. 19.6%; hazard ratio [HR]: 1.31; 95% CI: 1.09 to 1.58) and a composite of mortality or heart failure admission (37.3% vs. 28.5%; hazard ratio HR: 1.33; 95% CI: 1.13 to 1.56) at 1 year but not with heart failure admission alone (16.5% vs. 12.9%; HR: 1.23; 95% CI: 0.92 to 1.63).
CONCLUSIONS Early PPM implantation is a common complication following TAVR, and it is associated with higher mortality and a composite of mortality or heart failure admission at 1 year.
Metrics
1 Record Views
Details
- Title
- Incidence, Predictors, and Outcomes of Permanent Pacemaker Implantation Following Transcatheter Aortic Analysis From the US Society of Thoracic Surgeons/American College of Cardiology TVT Registry
- Creators
- Opeyemi O. Fadahunsi - Reading HospitalAbiola Olowoyeye - Children's Hospital of Los AngelesAnene Ukaigwe - Penn State Milton S. Hershey Medical CenterZhuokai Li - Duke Medical CenterAmit N. Vora - Duke Medical CenterSreekanth Vemulapalli - Clinical Research InstituteEric Elgin - Jefferson CollegeAnthony Donato - Reading Hospital
- Publication Details
- JACC. Cardiovascular interventions, v 9(21), pp 2189-2199
- Publisher
- Elsevier
- Number of pages
- 11
- Grant note
- American College of Cardiology Philips Medical Systems T32 HL069749; L30 HL124592 / National Institutes of Health T-32 training grant; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Boston Scientific Agency for Healthcare Research and Quality; United States Department of Health & Human Services; Agency for Healthcare Research & Quality Novella and Premiere Abbott Vascular; Abbott Laboratories American College of Cardiology Foundation's STS/ACC TVT Registry
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Web of Science ID
- WOS:000392617300005
- Scopus ID
- 2-s2.0-84994410157
- Other Identifier
- 991022161839604721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
Highly Cited Paper
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems