Valvular & structural heart disease
Clinical impact of right ventricular pacing burden in patients with post-transcatheter aortic valve replacement permanent pacemaker implantation
Authors' conclusion
The RVPB ≥30% at 1 year was associated with worse outcomes.
Study context
- Population
- Consecutive patients with permanent pacemaker (PPM) implantation after transcatheter aortic valve replacement (TAVR), 11 March 2011 to 9 November 2019of 1389 TAVR patients
- Participants
- 110 patients
- Exposure
- Right ventricular pacing burden (RVPB) ≥30% vs <30% at 1 year
- Outcome
- Heart failure (HF) readmission; overall death and/or HF
Methodological detailssingle-centre, consecutive patients, landmark analysis (cut-off 1 year after PPM implantation)
- Single-centre
- Consecutive patients
- Landmark analysis (cut-off 1 year after PPM implantation)
Main finding
As reported in the abstract
RVPB ≥30% vs RVPB <30%Adjusted hazard ratio (95% CI)P value
HF readmission
6.333(1.417–28.311)
P = 0.016Composite of overall death and/or HF
2.453(1.040–5.786)
P = 0.040Observational data: associations, not effects.
Further findings
AF burden
P = 0.013
Predictors of RVPB ≥30% at 1 year
| aHR (95% CI) | P value | ||
|---|---|---|---|
| RVPB ≥40% at 1 month | 57.808 (12.489–267.584) | P < 0.001 | |
| Valve implantation depth from non-coronary cusp ≥4.0 mm | 6.817 (1.829–25.402) | P = 0.004 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | RVPB ≥30% | RVPB <30% | P value |
|---|---|---|---|
| Change in LVEF | −5.0 (SD 9.8) % | + 1.1 (SD 7.9) % | P = 0.005 |
Original publication
Clinical impact of right ventricular pacing burden in patients with post-transcatheter aortic valve replacement permanent pacemaker implantation. Europace. Published 16 February 2023. doi:10.
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