| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | JACC: Cardiovascular Interventions | ||||
| Verlag: | ELSEVIER SCIENCE INC | ||||
| Ort der Veröffentlichung: | NEW YORK | ||||
| Band: | 12 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 18 | ||||
| Seitenbereich: | S. 1781-1793 | ||||
| Datum: | 2019 | ||||
| Institutionen: | Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | REPOSITIONABLE LOTUS VALVE; INTERMEDIATE-RISK PATIENTS; SEVERE AORTIC-STENOSIS; SAPIEN 3; CONSENSUS DOCUMENT; CLINICAL-OUTCOMES; REPLACEMENT; PREDICTORS; EXPERIENCE; SOCIETY; ACURATE neo; permanent pacemaker implantations; right bundle branch block; SAPIEN 3; transcatheter aortic valve replacement | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 48237 |
Web of ScienceZusammenfassung
OBJECTIVES This study sought to evaluate the impact of the ACURATE neo (NEO) (Boston Scientific, Marlborough, Massachusetts) versus SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) on permanent pacemaker implantation (PPI) in patients with pre-existing right bundle branch block (RBBB) after transcatheter aortic valve replacement. BACKGROUND Pre-existing RBBB is the strongest ...
Zusammenfassung
OBJECTIVES This study sought to evaluate the impact of the ACURATE neo (NEO) (Boston Scientific, Marlborough, Massachusetts) versus SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) on permanent pacemaker implantation (PPI) in patients with pre-existing right bundle branch block (RBBB) after transcatheter aortic valve replacement. BACKGROUND Pre-existing RBBB is the strongest patient-related predictor for PPI after transcatheter aortic valve replacement. No comparison of newer-generation transcatheter heart valves with regard to PPI in these patients exists. METHODS This multicenter registry includes 4,305 patients; 296 (6.9%) had pre-existent RBBB and no pacemaker at baseline and formed the study population. The primary endpoint was new PPI at 30 days. The association of NEO versus S3 with PPI was assessed using binary logistic regression analyses and inverse probability treatment weighting in a propensity-matched population. RESULTS The 30-day PPI rate was 39.2%. The S3 and NEO were used in 66.9% and 33.1%, respectively. The NEO was associated with lower rates of PPI compared with the S3 (29.6% vs. 43.9%; p = 0.025; odds ratio [OR]: 0.54; 95% confidence interval [CI]: 0.32 to 0.89; p = 0.018), after multivariable adjustment (OR: 0.48; 95% CI: 0.26 to 0.86; p = 0.014), and in the inverse probability treatment weighting analysis (OR: 0.37; 95% CI: 0.25 to 0.55; p < 0.001). There was no difference in device failure (8.2% vs. 6.6%; p = 0.792) or in-hospital course. In the propensity-matched population, PPI rate was also lower in the NEO versus S3 (23.1% vs. 44.6%; p = 0.016; OR: 0.37; 95% CI: 0.17 to 0.78; p = 0.010), with no difference in device failure (9.2% vs. 6.2%; p = 0.742). CONCLUSIONS In patients with RBBB, risk of PPI was significantly lower with the NEO compared with the S3, suggesting the possibility of a patient tailored transcatheter heart valve therapy. (C) 2019 by the American College of Cardiology Foundation.
Metadaten zuletzt geändert: 03 Sep 2021 09:44
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