Valvular & structural heart disease
Anatomical variations in permanent pacemaker requirement after TAVI in bicuspid anatomy
Authors' conclusion
PPMI risk differs significantly between BAV subtypes, possibly due to variations in MS proximity to the stent. The new BAV classification method may improve PPMI risk prediction and patient management.
Study context
- Population
- Bicuspid aortic valve (BAV) patients with severe aortic stenosis who underwent self-expanding TAVIBAV patients with severe aortic stenosis who underwent self-expanding TAVI
- Participants
- 300 patients
- Exposure
- Permanent pacemaker implantation (PPMI) risk following self-expanding TAVI among BAV subtypes
- BAV with MS below commissure (BAV-MSBC)n = 128
- BAV with MS below leaflet (BAV-MSBL)n = 172
- Outcome
- PPMI rate
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Risk factors of PPMI (multivariate analysis)
| OR (95% CI) | P value | ||
|---|---|---|---|
| BAV-MSBCRisk factor | 10.15 (4.07–25.34) | P < 0.001 | |
| Previous AVB IRisk factor | 4.15 (1.32–13.04) | P = 0.015 | |
| Right bundle branch blockRisk factor | 26.39 (4.81–144.82) | P < 0.001 | |
| △MSID-RCCProtective | 0.78 (0.70–0.86) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Multivariate model discrimination
- AUC
- 0.887 (95% CI: 0.843-0.930)
Original publication
Anatomical variations in permanent pacemaker requirement after TAVI in bicuspid anatomy. Eur Heart J Cardiovasc Imaging. Published 17 September 2025. doi:10.
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