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Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation: Impact on Late Clinical Outcomes and Left Ventricular Function

Open access
Urena, Marina, Webb, John G., Tamburino, Corrado, Muñoz-García, Antonio J., Cheema, Asim, Dager, Antonio E., Serra, Vicenç, Amat-Santos, Ignacio J., Barbanti, Marco, Immè, Sebastiano, Briales, Juan H. Alonso, Benitez, Luis Miguel, Al Lawati, Hatim, Cucalon, Angela Maria, García del Blanco, Bruno, López, Javier, Dumont, Eric, DeLarochellière, Robert, Ribeiro, Henrique B., Nombela-Franco, Luis, Philippon, François, Rodés-Cabau, Josep·2014·Circulation

Abstract

Background—: Very few data exist on the clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation. The objective of this study was to assess the impact of PPI after transcatheter aortic valve implantation on late outcomes in a large cohort of patients. Methods and Results—: A total of 1556 consecutive patients without prior PPI undergoing transcatheter aortic valve implantation were included. Of them, 239 patients (15.4%) required a PPI within the first 30 days after transcatheter aortic valve implantation. At a mean follow-up of 22±17 months, no association was observed between the need for 30-day PPI and all-cause mortality (hazard ratio, 0.98; 95% confidence interval, 0.74–1.30; P =0.871), cardiovascular mortality (hazard ratio, 0.81; 95% confidence interval, 0.56–1.17; P =0.270), and all-cause mortality or rehospitalization for heart failure (hazard ratio, 1.00; 95% confidence interval, 0.77–1.30; P =0.980). A lower rate of unexpected (sudden or unknown) death was observed in patients with PPI (hazard ratio, 0.31; 95% confidence interval, 0.11–0.85; P =0.023). Patients with new PPI showed a poorer evolution of left ventricular ejection fraction over time ( P =0.017), and new PPI was an independent predictor of left ventricular ejection fraction decrease at the 6- to 12-month follow-up (estimated coefficient, −2.26; 95% confidence interval, −4.07 to −0.44; P =0.013; R 2 =0.121). Conclusions—: The need for PPI was a frequent complication of transcatheter aortic valve implantation, but it was not associated with any increase in overall or cardiovascular death or rehospitalization for heart failure after a mean follow-up of ≈2 years. Indeed, 30-day PPI was a protective factor for the occurrence of unexpected (sudden or unknown) death. However, new PPI did have a negative effect on left ventricular function over time.

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Metadata

Authors
Urena, M., Webb, J. G., Tamburino, C., Muñoz-García, A. J., Cheema, A., Dager, A. E., Serra, V., Amat-Santos, I. J., Barbanti, M., Immè, S., Briales, J. H. A., Benitez, L. M., Al Lawati, H., Cucalon, A. M., García del Blanco, B., López, J., Dumont, E., DeLarochellière, R., Ribeiro, H. B., Nombela-Franco, L., Philippon, F., & Rodés-Cabau, J.
Venue
Circulation
Published
2014-03-18
Volume
129
Issue
11
Pages
1233-1243
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2611968684
Cited by
304
References
6
FWCI
16.95
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation: Impact on Late Clinical Outcomes and Left Ventricular Function. https://app.cochat.ai/papers/10.1161/circulationaha.113.005479
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Urena, M., Webb, J. G., Tamburino, C., Muñoz-García, A. J., Cheema, A., Dager, A. E., Serra, V., Amat-Santos, I. J., Barbanti, M., Immè, S., Briales, J. H. A., Benitez, L. M., Al Lawati, H., Cucalon, A. M., García del Blanco, B., López, J., Dumont, E., DeLarochellière, R., Ribeiro, H. B., . . . Rodés-Cabau, J. (2014). Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation: Impact on Late Clinical Outcomes and Left Ventricular Function. Circulation. https://doi.org/10.1161/circulationaha.113.005479

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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.