Arrhythmias & electrophysiology

Conduction System Versus Right Ventricular Pacing in Patients Undergoing Transcatheter Aortic Valve Replacement (TAVR): A Multicenter Propensity-Matched Study

JACC Cardiovasc IntervPublished retrospective, multicenter nationwide registry

Main finding · Composite of cardiovascular death or HF hospitalizationResult — go to the resultHazard ratio 0.57 95% CI 0.39–0.83

Authors' conclusion

In this multicenter propensity score-matched study, CPP after TAVR was associated with a lower risk of the primary endpoint, driven by fewer HF hospitalizations. These findings support the need for further randomized clinical trials to evaluate the role of CPP in post-TAVR patients requiring ventricular pacing.

Study context

Population
Patients undergoing TAVR and pacemaker implantation within 30 days
Participants
466 matched pairs
Exposure
Cardiac physiological pacing (CPP) vs right ventricular pacing (RVP) in patients requiring permanent pacing after TAVR
Outcome
Composite of:
  • Cardiovascular death
  • Heart failure (HF) hospitalization
Follow-up
Median 24 months
Methodological detailspropensity score matching (1:1)
  • Propensity score matching (1:1)

Main finding

As reported in the abstract

Hazard ratio

0.57

95% CI 0.39–0.83

P = 0.003

By group

CPPvs RVP
HR 0.57 (95% CI 0.39–0.83); P = 0.003

Observational data: associations, not effects.

Further findings

OutcomeCPPRVPHR (95% CI)P value
HF hospitalizations7.9%13.9%0.57 (0.37–0.86)P = 0.008

Cardiovascular death or all-cause mortality

No significant differences between groups

Original publication

Conduction System Versus Right Ventricular Pacing in Patients Undergoing TAVR: A Multicenter Propensity-Matched Study. JACC Cardiovasc Interv. Published 12 October 2026. doi:10.1016/j.jcin.2026.08.008

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