Introduction of Permanent Pacemaker Implantation After TAVR – Predictors And Impact On Outcomes

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Summary

Transcatheter aortic valve replacement (TAVR) has emerged as the treatment of choice among inoperable patients with symptomatic severe aortic stenosis and as a treatment alternative to surgical aortic valve replacement (SAVR) for high-risk surgical patients1–3. Subsequently, the number of patients undergoing TAVR worldwide is steadily increasing and the complications related to valve implantation have been well-recognised.

Conduction disturbances after SAVR have been extensively documented and are in part predicted by pre-existing conduction abnormalities4. According to recent data, PPM implantation is necessary in approximately five per cent of patients undergoing SAVR. Among transcatheter heart valves (THV), rates of conduction abnormalities vary from less than 10 % to more than 50 %. Depending on the reported data referred to, historical data showed that up to one-third of patients required implantation of a PPM following TAVR5. Since the debate about predictors for pacemaker implantation and their impact on outcome after TAVR is still ongoing, this review will assess the current status quo.

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