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Permanent Pacemaker Insertion After CoreValve Transcatheter Aortic Valve Implantation: Incidence and Contributing Factors (the UK CoreValve Collaborative)
Abstract
Background—: Permanent pacemaker (PPM) requirement is a recognized complication of transcatheter aortic valve implantation. We assessed the UK incidence of permanent pacing within 30 days of CoreValve implantation and formulated an anatomic and electrophysiological model. Methods and Results—: Data from 270 patients at 10 centers in the United Kingdom were examined. Twenty-five patients (8%) had preexisting PPMs; 2 patients had incomplete data. The remaining 243 were 81.3±6.7 years of age; 50.6% were male. QRS duration increased from 105±23 to 135±29 milliseconds ( P <0.01). Left bundle-branch block incidence was 13% at baseline and 61% after the procedure ( P <0.001). Eighty-one patients (33.3%) required a PPM within 30 days. Rates of pacing according to preexisting ECG abnormalities were as follows: right bundle-branch block, 65.2%; left bundle-branch block, 43.75%; normal QRS, 27.6%. Among patients who required PPM implantation, the median time to insertion was 4.0 days (interquartile range, 2.0 to 7.75 days). Multivariable analysis revealed that periprocedural atrioventricular block (odds ratio, 6.29; 95% confidence interval, 3.55 to 11.15), balloon predilatation (odds ratio, 2.68; 95% confidence interval, 2.00 to 3.47), use of the larger (29 mm) CoreValve prosthesis (odds ratio, 2.50; 95% confidence interval, 1.22 to 5.11), interventricular septum diameter (odds ratio, 1.18; 95% confidence interval, 1.10 to 3.06), and prolonged QRS duration (odds ratio, 3.45; 95% confidence interval, 1.61 to 7.40) were independently associated with the need for PPM. Conclusion—: One third of patients undergoing a CoreValve transcatheter aortic valve implantation procedure require a PPM within 30 days. Periprocedural atrioventricular block, balloon predilatation, use of the larger CoreValve prosthesis, increased interventricular septum diameter and prolonged QRS duration were associated with the need for PPM.
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Iung, B. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00201-x · Cited by 3,530
Clinical Factors Associated With Calcific Aortic Valve Disease
Stewart, B. F., Siscovick, D., Lind, B. K., Gardin, J. M., Gottdiener, J. S., Smith, V. E., Kitzman, D. W., & Otto, C. M. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00563-3 · Cited by 2,029
Cited by
Popma, J. J., Adams, D. H., Reardon, M. J., Yakubov, S. J., Kleiman, N. S., Heimansohn, D., Hermiller, J., Hughes, G. C., Harrison, J. K., Coselli, J., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.02.556 · Cited by 1,040
Moat, N. E., Ludman, P., de Belder, M. A., Bridgewater, B., Cunningham, A. D., Young, C. P., Thomas, M., Kovac, J., Spyt, T., MacCarthy, P. A., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.08.050 · Cited by 884
Self-citationTranscatheter aortic valve implantation: current and future approaches
Rodés-Cabau, J. (2012) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2011.164 · Cited by 306
Metadata
- Authors
- Khawaja, M. Z., Rajani, R., Cook, A., Khavandi, A., Moynagh, A., Chowdhary, S., Spence, M. S., Brown, S., Khan, S. Q., Walker, N., Trivedi, U., Hutchinson, N., De Belder, A. J., Moat, N., Blackman, D. J., Levy, R. D., Manoharan, G., Roberts, D., Khogali, S. S., Crean, P., Brecker, S. J., Baumbach, A., Mullen, M., Laborde, J.-C., & Hildick-Smith, D.
- Venue
- Circulation
- Published
- 2011-03-08
- Volume
- 123
- Issue
- 9
- Pages
- 951-960
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2022851384
- Cited by
- 313
- References
- 2
- FWCI
- 32.40
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Permanent Pacemaker Insertion After CoreValve Transcatheter Aortic Valve Implantation: Incidence and Contributing Factors (the UK CoreValve Collaborative). https://app.cochat.ai/papers/10.1161/circulationaha.109.927152
- The paper
- Khawaja, M. Z., Rajani, R., Cook, A., Khavandi, A., Moynagh, A., Chowdhary, S., Spence, M. S., Brown, S., Khan, S. Q., Walker, N., Trivedi, U., Hutchinson, N., De Belder, A. J., Moat, N., Blackman, D. J., Levy, R. D., Manoharan, G., Roberts, D., Khogali, S. S., . . . Hildick-Smith, D. (2011). Permanent Pacemaker Insertion After CoreValve Transcatheter Aortic Valve Implantation: Incidence and Contributing Factors (the UK CoreValve Collaborative). Circulation. https://doi.org/10.1161/circulationaha.109.927152
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.