Author + information
- Paul Fefer,
- Scott Kohen,
- Andrada Bogdan,
- Victor Guetta,
- Elad Asher,
- Elad Maor,
- Dan Elian,
- Ehud Regev,
- Noam Fink,
- Amit Segev and
- Israel M. Barbash
Background: Rapid ventricular pacing (RVP) is frequently performed during transcatheter aortic valve replacement (TAVR) in order to temporarily reduce cardiac output. The clinical impact of these hypotensive episodes is unknown. Our aim was to assess correlation between RVP, its duration, and clinical outcome.
Methods: Retrospective data was collected on all patients undergoing TAVR during the years 2008-2014 at single tertiary hospital. Comprehensive review of heart rhythm and invasive arterial pressure recordings were performed using the full disclosure of source procedural data. Patients with RVP were divided into tertiles based on maximal pacing duration and were compared to patients without RVP.
Results: RVP was performed in 282/345 (81%) patients. Mean pacing duration was 17.6±8 seconds. No differences between groups were documented apart from higher rates of coronary artery disease among RVP patients. Procedural parameters and outcome were comparable. However combined end-point of procedural hypotension, asystole, acute kidney injury and in-hospital mortality were significantly more frequent among RVP patients (25%, 35%, 27% according to duration tertile) as compared to no RVP patients (9.5%) (p=0.003). Long term mortality was significantly higher for RVP patients (p=0.015) (Figure).
Conclusions: Patients who underwent any RVP during TAVR had worse short- and long-term outcomes as compared to patients without RVP. However, pacing duration did not impact outcome.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 4
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1283-146
- 2017 American College of Cardiology Foundation