Author + information
- Ijeoma Ananaba Ekeruo,
- Omar Hadidi,
- Yelin Zhao,
- Richard Smalling,
- Biswajit Kar,
- Pranav Loyalka,
- Daniel Ocazionez and
- Prakash Balan
Background: Prior studies have documented permanent pacemaker (PPM) placement as a complication following transcatheter aortic valve replacement (TAVR). However, the risk factors predicting PPM placement have not been well defined. We present our experience at a high volume TAVR center to help answer this question.
Methods: Between 2011 and 2014, 459 TAVR procedures were performed at our institution, with 52 PPMs placed (11.3%) in that period. Propensity matching between patients with PPM implants following TAVR and those without yielded 40 pairs for a case control analysis. 11 potential risk factors were studied, including the presence of pre-existing conduction abnormalities, prosthesis LVOT height, presence of mitral annular calcification (MAC), performance of balloon valvuloplasty (BAV) prior to TAVR and calculated aortic annular calcium, with the differences compared using the student's t-test and χ2 analysis.
Results: The majority of patients (68%) received PPMs due to complete heart block during or after the TAVR procedure. There were significant differences in pre-procedure PR interval, QRS duration, history of RBBB and pre-existing 1°/2° AV block between the groups. The depth of the prosthesis into the LVOT was also deemed significant in this study.
Conclusions: In addition to known risk factors for PPM placement, pre-existing AV block is also a significant predictor of post TAVR PPM implantation in this population. Further study is warranted to better evaluate this relationship.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: PCI and TAVR in Complex Patients
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1239-128
- 2017 American College of Cardiology Foundation