Arrhythmias & electrophysiologyCohort study
Conduction system pacing in transcatheter aortic valve replacement patients requiring permanent pacemaker implantation
- observational multicenter study
- consecutive patients
- propensity matched
Authors' conclusion
In TAVR patients requiring PPM, CSP was associated with improved clinical outcomes at 1-year follow-up compared to RVP. Prospective randomized studies are needed to confirm longer-term benefits and refine patient selection.
Study context
- Population
- Consecutive patients requiring permanent pacemaker (PPM) implantation within 30 days after transcatheter aortic valve replacement (TAVR)after propensity score matching
- Participants
- 706 patients
- Exposure
- Conduction system pacing (CSP) compared to right ventricular pacing (RVP)
- CSPn = 185
- RVPn = 521reference
- Outcome
- Composite of:
- Death
- Heart failure hospitalization
- Follow-up
- 1-year follow-up
Main finding
As reported in the abstract
Adjusted hazard ratio
0.48
95% CI 0.30–0.78
P = 0.003
By group
CSP vs RVP
adjusted HR 0.48 (95% CI 0.30–0.78); P = 0.003
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| All-cause mortality | 0.52 (0.28–0.96) | P = 0.036 | |
| Heart-failure hospitalization | 0.50 (0.25–0.99) | P = 0.049 | |
| 0.20.5125Hazard ratio (log scale) |
QRS duration · 30 days · shorter with CSP
P < 0.001
Left ventricular ejection fraction · 1-year follow-up
- Improvement with CSP
- +2.8 percentage points; P < .001
Original publication
Conduction system pacing in transcatheter aortic valve replacement patients requiring permanent pacemaker implantation. Heart Rhythm. Published 1 July 2026. doi:10.1016/j.hrthm.2026.06.032
Summarised from the published abstract; every number is checked against it