Direkt zum Inhalt

Tichelbäcker, Tobias ; Bergau, Leonard ; Puls, Miriam ; Friede, Tim ; Mütze, Tobias ; Maier, Lars Siegfried ; Frey, Norbert ; Hasenfuß, Gerd ; Zabel, Markus ; Jacobshagen, Claudius ; Sossalla, Samuel

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.



Beteiligte Einrichtungen


Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftPLOS ONE
Verlag:PLOS
Ort der Veröffentlichung:SAN FRANCISCO
Band:13
Nummer des Zeitschriftenheftes oder des Kapitels:10
Seitenbereich:e0204503
Datum17 Oktober 2018
InstitutionenMedizin > Lehrstuhl für Innere Medizin II
Identifikationsnummer
WertTyp
10.1371/journal.pone.0204503DOI
Stichwörter / KeywordsAORTIC-VALVE-REPLACEMENT; INTERMEDIATE-RISK PATIENTS; CONDUCTION ABNORMALITIES; TRANSCATHETER; PREDICTORS; REGURGITATION; REGISTRY; COMPLICATIONS; OUTCOMES; DEVICE;
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-378819
Dokumenten-ID37881

Bibliographische Daten exportieren

Nur für Besitzer und Autoren: Kontrollseite des Eintrags

nach oben