Implanting permanent pacemakers following TAVR could worsen outcomes: 4 findings

Implanting a permanent pacemaker after transcatheter aortic valve replacement is associated with poor outcomes, such as higher mortality and heart failure admission at one year post-procedure, according to a study in JACC: Cardiovascular Interventions.

Researchers conducted a retrospective cohort study of patients undergoing TAVR at 229 U.S. sites between November 2011 and September 2014. They used the Society of Thoracic Surgeons/American College of Cardiology TVT Registry and the CMS database.

Here are four findings:

1. Permanent pacemaker placement was required within 30 days of TAVR in 651 of the 9,785 patients (6.7 percent).

2. Age, prior conduction defect and use of self-expanding valve were positive predictors of pacemaker implantation.

3. Permanent pacemaker implantation was associated with a seven-day median hospital stay and 56.7-hour intensive care unit stay.

4. Permanent pacemaker implantation was also associated with a 24.1 percent mortality rate.

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