Reported Versus “Real” Incidence of New Pacemaker Implantation Post-Transcatheter Aortic Valve Replacement

Cardiac conduction disturbances requiring permanent pacemaker (PPM) implantation remain the most frequent complication of transcatheter aortic valve replacement (TAVR). PPM rates of approximately 6% (ranging from 2% to 14%) for the balloon-expandable valve system (BEV, Edwards Lifesciences, Irvine, California), and 28% (ranging from 16% to 51%) for the self-expanding valve system (SEV, Corevalve, Medtronic, Minneapolis, Minnesota) have been reported(1). Rates of new PPM implantation are also reportedly higher with certain newer-generation transcatheter valve systems(1). However, to date, most studies have reported the PPM rates following TAVR without excluding those patients with prior pacemaker. The inclusion of patients who are not at risk for this specific complication may have translated into a significant underestimation of the real incidence of PPM following TAVR, and introduces a major bias when informing patients about the real risks of PPM following the TAVR procedure. Therefore, this study ’s objective was to estimate the “real” incidence of PPM following TAVR and to compare it with the incidence reported by the TAVR studies.
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research