1. Long-term clinical impact of permanent cardiac pacing after transcatheter aortic valve implantation with the CoreValve prosthesis: a single center experience.
- Author
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López-Aguilera J, Segura Saint-Gerons JM, Sánchez Fernández J, Mazuelos Bellido F, Pan Álvarez-Ossorio M, Suárez de Lezo J, Romero Moreno M, Ojeda Pineda S, Pavlovic D, Mesa Rubio D, Rodriguez Diego S, Ferreiro C, Durán E, Chavarría J, Moya González J, and Suárez de Lezo J
- Subjects
- Aged, Aged, 80 and over, Cardiac Catheterization methods, Female, Humans, Male, Outcome and Process Assessment, Health Care, Patient Readmission statistics & numerical data, Prosthesis Design, Risk Adjustment methods, Spain epidemiology, Time, Aortic Valve, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Cardiac Pacing, Artificial methods, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement methods
- Abstract
Aims: To determine the impact of permanent cardiac pacing after transcatheter aortic valve implantation (TAVI) with the CoreValveTM prosthesis in terms of all-cause mortality and morbidity [rehospitalizations for heart failure (HF) or stroke] at the long-term follow-up., Methods and Results: The prospective analysis comprised 259 patients (138 women, 53.3%, age 78 ± 6 years) treated by a CoreValveTM prosthesis from April 2008 to December 2015. Forty-two patients were excluded for analysis: 9 with pre-existing permanent pacemaker (PPM) implantation, 19 who required a PPM during the follow-up and 14 patients because of hospital mortality during or after the CoreValveTM prosthesis implantation procedure. The remaining 217 patients were divided in two groups: Group-1 included those patients who required a PPM immediately after TAVI, and Group-2 included those patients who did not require permanent cardiac pacing at the long-term follow-up. Patients received follow-up at 1-month, 6-months, 12-months, and yearly thereafter. A total of 39 patients required a PPM immediately after TAVI (15.0%), but 178 patients (68.7%) did not. The mean follow-up was 37 ± 27 months (range 3-99 months) in both groups. There was no difference between the two groups in terms of all-cause mortality (52.6% vs. 56.8%, P = 0.125; HR 1.22 [0.87-1.77, 95% CI]), or stroke (13.3% vs. 15.1% P = 0.842; HR 1.12 [0.37-3.32, 95% CI]). However, patients who underwent PPM implantation developed an increase in readmissions for HF (21.1% vs. 31.9%, P = 0.015; HR 1.82 [1.23-3.92, 95% CI])., Conclusion: Patients requiring a PPM after TAVI did not have an increase in mortality, or an increase in the likelihood of developing a stroke at a long-term follow-up. However, this subgroup of patients showed an increase in rehospitalization due to HF at medium- and long-term follow-up.
- Published
- 2018
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