| Download ( PDF | 996kB) | Lizenz: Creative Commons Namensnennung 4.0 International |
Insights into permanent pacemaker implantation following TAVR in a real-world cohort
Tichelbäcker, Tobias, Bergau, Leonard, Puls, Miriam, Friede, Tim
, Mütze, Tobias, Maier, Lars Siegfried, Frey, Norbert, Hasenfuß, Gerd, Zabel, Markus, Jacobshagen, Claudius und Sossalla, Samuel
(2018)
Insights into permanent pacemaker implantation following TAVR in a real-world cohort.
PLOS ONE 13 (10), e0204503.
Veröffentlichungsdatum dieses Volltextes: 26 Okt 2018 09:07
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.37881
Zusammenfassung
Background Permanent pacemaker implantation (PPI) following TAVR is a frequent post interventional complication and its management remains controversial. Objective We sought to elucidate the electrophysiological, procedural, and clinical baseline parameters that are associated with and perhaps predict the need for PPI after TAVR in a heterogeneous-valve-type real-world cohort. Methods Overall, ...
Background Permanent pacemaker implantation (PPI) following TAVR is a frequent post interventional complication and its management remains controversial. Objective We sought to elucidate the electrophysiological, procedural, and clinical baseline parameters that are associated with and perhaps predict the need for PPI after TAVR in a heterogeneous-valve-type real-world cohort. Methods Overall, 494 patients receiving TAVR at our center from April 2009 to August 2015 were screened. ECG analyses and clinical parameters were collected prospectively. Results Overall, 401 patients in this all-comers real-world TAVR cohort with a PPI rate of 16% were included. The mean age was 82 years, and the mean duration to PPI was 5.5 days. A large proportion of Edwards SAPIEN valves (81%), DirectFlow, Core Valve, and Portico were implanted. The main indications for PPI were atrioventricular (AV) block III, AV-block Mobitz type II, bradycardic atrial fibrillation and persistent sinus bradycardia. Between groups with and without PPI, significant differences were noted in the prevalence of post TAVR balloon dilatation, resting heart rate, QRS interval, PR interval with a cut-off of >178 ms, left anterior fascicular block and RBBB in univariate analyses. In the subsequent multiple regression analysis, post TAVR balloon dilatation and a PR interval with a cut-off of >178 ms were significant predictors of PPI. Conclusion This real-world cohort differs from others in its size and heterogeneous valve selection, and indicates for the first time that patients with post balloon dilatation or prolonged PR interval are at a higher risk for pacemaker dependency after TAVR.
Alternative Links zum Volltext
Beteiligte Einrichtungen
Details
| Dokumentenart | Artikel | ||||
| Titel eines Journals oder einer Zeitschrift | PLOS ONE | ||||
| Verlag: | PLOS | ||||
|---|---|---|---|---|---|
| Ort der Veröffentlichung: | SAN FRANCISCO | ||||
| Band: | 13 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 10 | ||||
| Seitenbereich: | e0204503 | ||||
| Datum | 17 Oktober 2018 | ||||
| Institutionen | Medizin > Lehrstuhl für Innere Medizin II | ||||
| Identifikationsnummer |
| ||||
| Stichwörter / Keywords | AORTIC-VALVE-REPLACEMENT; INTERMEDIATE-RISK PATIENTS; CONDUCTION ABNORMALITIES; TRANSCATHETER; PREDICTORS; REGURGITATION; REGISTRY; COMPLICATIONS; OUTCOMES; DEVICE; | ||||
| Dewey-Dezimal-Klassifikation | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status | Veröffentlicht | ||||
| Begutachtet | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden | Ja | ||||
| URN der UB Regensburg | urn:nbn:de:bvb:355-epub-378819 | ||||
| Dokumenten-ID | 37881 |
Downloadstatistik
Downloadstatistik