Valvular & structural heart disease
Prophylactic Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement
Authors' conclusion
About one fourth of patients receiving PPI after TAVR had a prophylactic indication. Despite similar clinical outcomes, prophylactic PPI patients exhibited a very low pacing burden at 30 days.
Study context
- Population
- Patients without prior pacemaker undergoing transcatheter aortic valve replacement (TAVR) who received permanent pacemaker implantation (PPI) post-TAVRPPI post-TAVR
- Participants
- 329 patients
- Comparison
- Prophylactic PPI vs Nonprophylactic PPI
- Prophylactic PPIn = 80
- Primary endpoint
- Incidence and clinical impact of prophylactic PPI after TAVR
Methodological detailsprespecified subanalysis, prospective, multicentre
- Prespecified subanalysis
- Prospective
- Multicentre
Primary result
As reported in the abstract
Incidence of prophylactic PPI indication
Prophylactic PPI
24.3%
80
- Main indication: new-onset persistent LBBB with QRS >150 ms and/or PR >240 ms
- 90%
Further findings
Ventricular pacing percentage Prophylactic PPI median 2% · Nonprophylactic PPI median 73%
Ventricular pacing <1%
- Ventricular pacing percentage: median pacing P < 0.001
- Ventricular pacing percentage: pacing <1% P < 0.001
- Pacing burden, prophylactic PPI after positive electrophysiological study (His-Ventricle interval ≥70 ms) vs no electrophysiological study: Positive electrophysiological study median 2.0%
- Pacing burden, prophylactic PPI after positive electrophysiological study (His-Ventricle interval ≥70 ms) vs no electrophysiological study: No electrophysiological study median 1.9%
- Pacing burden, prophylactic PPI after positive electrophysiological study (His-Ventricle interval ≥70 ms) vs no electrophysiological study: P = 0.585
30-day clinical outcomes
- Similar in prophylactic and nonprophylactic PPI patients
Original publication
Prophylactic Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement. JACC Clin Electrophysiol. Published 17 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it