Predictors of pacemaker implantation after transcatheter aortic valve implantation according to kind of prosthesis and risk profile : a systematic review and contemporary meta-analysis
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com..
AIMS: Permanent pacemaker implantation (PPI) may be required after transcatheter aortic valve implantation (TAVI). Evidence on PPI prediction has largely been gathered from high-risk patients receiving first-generation valve implants. We undertook a meta-analysis of the existing literature to examine the incidence and predictors of PPI after TAVI according to generation of valve, valve type, and surgical risk.
METHODS AND RESULTS: We made a systematic literature search for studies with ≥100 patients reporting the incidence and adjusted predictors of PPI after TAVI. Subgroup analyses examined these features according to generation of valve, specific valve type, and surgical risk. We obtained data from 43 studies, encompassing 29 113 patients. Permanent pacemaker implantation rates ranged from 6.7% to 39.2% in individual studies with a pooled incidence of 19% (95% CI 16-21). Independent predictors for PPI were age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.09], left bundle branch block (LBBB) (OR 1.45, 95% CI 1.12-1.77), right bundle branch block (RBBB) (OR 4.15, 95% CI 3.23-4.88), implantation depth (OR 1.18, 95% CI 1.11-1.26), and self-expanding valve prosthesis (OR 2.99, 95% CI 1.39-4.59). Among subgroups analysed according to valve type, valve generation and surgical risk, independent predictors were RBBB, self-expanding valve type, first-degree atrioventricular block, and implantation depth.
CONCLUSIONS: The principle independent predictors for PPI following TAVI are age, RBBB, LBBB, self-expanding valve type, and valve implantation depth. These characteristics should be taken into account in pre-procedural assessment to reduce PPI rates. PROSPERO ID CRD42020164043.
| Errataetall: |
CommentIn: Eur Heart J Qual Care Clin Outcomes. 2021 Mar 15;7(2):114-116. - PMID 33416879 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
European heart journal. Quality of care & clinical outcomes - 7(2021), 2 vom: 15. März, Seite 143-153 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bruno, Francesco [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic stenosis |
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| Anmerkungen: |
Date Completed 06.12.2021 Date Revised 14.12.2021 published: Print CommentIn: Eur Heart J Qual Care Clin Outcomes. 2021 Mar 15;7(2):114-116. - PMID 33416879 Citation Status MEDLINE |
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| doi: |
10.1093/ehjqcco/qcaa089 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318552019 |
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| 100 | 1 | |a Bruno, Francesco |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictors of pacemaker implantation after transcatheter aortic valve implantation according to kind of prosthesis and risk profile |b a systematic review and contemporary meta-analysis |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 06.12.2021 | ||
| 500 | |a Date Revised 14.12.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Eur Heart J Qual Care Clin Outcomes. 2021 Mar 15;7(2):114-116. - PMID 33416879 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Permanent pacemaker implantation (PPI) may be required after transcatheter aortic valve implantation (TAVI). Evidence on PPI prediction has largely been gathered from high-risk patients receiving first-generation valve implants. We undertook a meta-analysis of the existing literature to examine the incidence and predictors of PPI after TAVI according to generation of valve, valve type, and surgical risk | ||
| 520 | |a METHODS AND RESULTS: We made a systematic literature search for studies with ≥100 patients reporting the incidence and adjusted predictors of PPI after TAVI. Subgroup analyses examined these features according to generation of valve, specific valve type, and surgical risk. We obtained data from 43 studies, encompassing 29 113 patients. Permanent pacemaker implantation rates ranged from 6.7% to 39.2% in individual studies with a pooled incidence of 19% (95% CI 16-21). Independent predictors for PPI were age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.09], left bundle branch block (LBBB) (OR 1.45, 95% CI 1.12-1.77), right bundle branch block (RBBB) (OR 4.15, 95% CI 3.23-4.88), implantation depth (OR 1.18, 95% CI 1.11-1.26), and self-expanding valve prosthesis (OR 2.99, 95% CI 1.39-4.59). Among subgroups analysed according to valve type, valve generation and surgical risk, independent predictors were RBBB, self-expanding valve type, first-degree atrioventricular block, and implantation depth | ||
| 520 | |a CONCLUSIONS: The principle independent predictors for PPI following TAVI are age, RBBB, LBBB, self-expanding valve type, and valve implantation depth. These characteristics should be taken into account in pre-procedural assessment to reduce PPI rates. PROSPERO ID CRD42020164043 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Aortic stenosis | |
| 650 | 4 | |a Conduction disturbances | |
| 650 | 4 | |a Permanent pacemaker | |
| 650 | 4 | |a Transcatheter aortic valve implantation | |
| 650 | 4 | |a Transcatheter aortic valve replacement | |
| 700 | 1 | |a D'Ascenzo, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Vaira, Matteo Pio |e verfasserin |4 aut | |
| 700 | 1 | |a Elia, Edoardo |e verfasserin |4 aut | |
| 700 | 1 | |a Omedè, Pierluigi |e verfasserin |4 aut | |
| 700 | 1 | |a Kodali, Susheel |e verfasserin |4 aut | |
| 700 | 1 | |a Barbanti, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Rodès-Cabau, Josep |e verfasserin |4 aut | |
| 700 | 1 | |a Husser, Oliver |e verfasserin |4 aut | |
| 700 | 1 | |a Sossalla, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Van Mieghem, Nicolas M |e verfasserin |4 aut | |
| 700 | 1 | |a Bax, Jeroen |e verfasserin |4 aut | |
| 700 | 1 | |a Hildick-Smith, David |e verfasserin |4 aut | |
| 700 | 1 | |a Munoz-Garcia, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Pollari, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Fischlein, Theodor |e verfasserin |4 aut | |
| 700 | 1 | |a Budano, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Montefusco, Antonio |e verfasserin |4 aut | |
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| 700 | 1 | |a Rinaldi, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a la Torre, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Salizzoni, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Atzeni, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Pocar, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Conrotto, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a De Ferrari, Gaetano Maria |e verfasserin |4 aut | |
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