New frontiers for improving outcomes after transcatheter aortic valve implantation: the role of the conduction system and the impact of pacemakers

Transcatheter aortic valve implantation (TAVI) is at least as safe and effective as surgical aortic valve replacement (SAVR) in patients with severe symptomatic aortic stenosis for the endpoints of all-cause mortality, stroke and heart failure hospitalizations across the spectrum of surgical risk1,2. Despite iterative advances in technology and refinements in procedural technique, conduction disturbances are not infrequent and occur more commonly after TAVI than after surgery. In the most recent low-risk randomized trials2,3 comparing TAVI to SAVR, the rates of permanent pacemaker implantation (PPI) were 6.6% with the balloon-expandable Sapien platform (versus 4.0% with SAVR) and 17.4% with the self-expanding Evolut platform (versus 6.1% with SAVR).
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research