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Predictors of Early and Late Atrioventricular Block Requiring Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Single-Center Experience
Journal article   Peer reviewed

Predictors of Early and Late Atrioventricular Block Requiring Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Single-Center Experience

Muhammad Zubair Khan, Ashwani Gupta, Sona Franklin, Aida Abraham, Ahmad Jarrar, Kirten Kumar Patel, Sarah Ahmad and Steven Kutalek
Cardiovascular revascularization medicine, v 42, pp 67-71
Sep 2022
DOI: https://doi.org/10.1016/j.carrev.2022.02.002
PMID: 35288044
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Atrial fibrillation Left bundle branch block Permanent pacemaker Transcatheter aortic valve replacement
Complete heart block requiring permanent pacemaker can occur early following transcatheter aortic valve replacement (TAVR) due to mechanical compression of the aortic valve annulus and associated atrio-ventricular (AV) conduction system. Data are limited regarding late PM implantation after TAVR. The purpose of this study was to determine predictors of early vs. late PM implantation post-TAVR procedure. Baseline characteristics of patients who required PM <7 days following TAVR were compared with patients who required a PM >7 days to 1 year following TAVR using Chi-Square and multivariate regression analysis. There were 362 TAVR patients, of which 39 (10.4%) received a PM after TAVR. Of these 18 (4.6%) patients required PM within 7 days after TAVR, and 21 (5.8%) required PM after 7 days and up to 1 year later. Right bundle branch block (RBBB) (OR 6.721, CI 2.3–36.9, p < 0.005) was a positive predictor of early PM placement. Left bundle branch block (LBBB) (OR = 3.5, CI 1.19–10.80, p-value < 0.05) and atrial fibrillation (AF) (OR = 3.5, 1.36–9.4 p < 0.05) were predictors for late PM. Early and late PM were associated with a longer median hospital stay compared to no PM (4.9 ± 4.86 days vs. 10.1 ± 10.04 days vs. 6.10 ± 6.02 days). The incidence of heart failure was higher in the late PM group. The overall motility was not increased in early and late PM compared to no PM. Patients requiring PM implant after TAVR was 10.4%, of which 5.8% need PM >7 days post-TAVR. RBBB is a predictor for early PM. AF and LBBB were predictors for late PM. •RBBB is risk factor of early PM implantation,•Patients with LBBB and AF is a risk factor of late PM implantation

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11 Record Views
7 citations in Web of Science
5 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Physics, Multidisciplinary
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