Valvular & structural heart disease
Long-Term Outcomes Associated With Permanent Pacemaker Implantation in Low-Risk Surgical Aortic Valve Replacement
Authors' conclusion
We found an increased incidence of heart failure in patients with low surgical risk who received a permanent pacemaker after SAVR. Permanent pacemaker implantation was not associated with all-cause mortality or endocarditis.
Study context
- Population
- Low-risk patients (logistic EuroSCORE I <10% or EuroSCORE II <4%) undergoing surgical aortic valve replacement (SAVR) in Sweden, 2001–2018; mean age 68 years, 33% women732 (3.7%) with pacemaker
- Participants
- 19,576 patients
- Exposure
- Permanent pacemaker within 30 days after SAVR vs no pacemaker
- Pacemakern = 732
- Outcome
- All-cause mortality, HF hospitalization and endocarditis
- Follow-up
- 17 years
Methodological detailsnationwide, population-based, regression standardization
- Nationwide
- Population-based
- Regression standardization
Main finding
As reported in the abstract
Pacemaker
28%
95% CI 24%–33%
Cumulative incidence of HF
No pacemaker
20%
95% CI 19%–22%
Cumulative incidence of HF
Estimate (95% CI)
Between Pacemaker and No pacemakerall-cause mortality, no difference
absolute survival difference 0.1 %(−3.6% to 3.8%)
Pacemakervs No pacemakerHF
absolute difference 8.2 %(3.8%–13%)
Observational data: associations, not effects.
Original publication
Long-Term Outcomes Associated With Permanent Pacemaker Implantation in Low-Risk Surgical Aortic Valve Replacement. JACC Adv. Published 18 July 2024. doi:10.
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