Anatomical and Functional Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation

Jung S, Kondruweit M, Marwan M, Achenbach S (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Journal of the American Heart Association Wiley

Book Volume: 14

Article Number: e039020

Journal Issue: 10

DOI: 10.1161/JAHA.124.039020

Abstract

BACKGROUND: High-degree atrioventricular block with the need for permanent pacemaker (PPM) implantation represents a frequent complication after transcatheter aortic valve implantation (TAVI). Extension of indication for TAVI toward subjects with lower surgical risk requires reduction of the likelihood for the need for PPM implantation. The aim of the current analysis was to identify predictors of the need for PPM implantation after TAVI. METHODS AND RESULTS: In a cohort of 1500 consecutive patients without a PPM undergoing transfemoral TAVI, clinical and procedural characteristics as well as parameters derived from cardiac computed tomography, such as membranous septal length and calcium volumes of the aortic valve cusps and the left ventricular outflow tract were assessed. Median calcium volume of the aortic valve was 552 mm³ (interquartile range [IQR]: 340–811 mm³) in the group of subjects requiring a PPM, which was higher than in the group of subjects not requiring PPM implantation (455 mm³ [IQR: 245–723 mm³], Padj =0.001). The same was true for calcification of the noncoronary cusp (Padj =0.027), left coronary cusp (Padj =0.033), and right coronary cusp (Padj =0.006). In multivariable analysis, calcium volume of the noncoronary cusp (P=0.039; odds ratio [OR], 1.089 per 100 mm³), preexisting complete right bundle-branch block (P<0.001; OR, 9.402), and implantation of a self-expandable prosthesis (P<0.001; OR, 1.856) were significantly associated with PPM implantation after TAVI. CONCLUSIONS: The current analysis offers a detailed examination of predictors for the need for PPM implantation after TAVI. Our results may contribute to improved risk stratification on the need for PPM implantation after TAVI.

Authors with CRIS profile

Markus Kondruweit Department of Cardiac Surgery Mohamed Marwan Department of Medicine 2 – Cardiology and Angiology Stephan Achenbach Lehrstuhl für Innere Medizin II

How to cite

APA:

Jung, S., Kondruweit, M., Marwan, M., & Achenbach, S. (2025). Anatomical and Functional Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation. Journal of the American Heart Association, 14(10). https://doi.org/10.1161/JAHA.124.039020

MLA:

Jung, Susanne, et al. "Anatomical and Functional Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation." Journal of the American Heart Association 14.10 (2025).

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