Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block
Background Right bundle branch block is an established predictor for new conduction disturbances and need for a permanent pacemaker (PPM) after transcatheter aortic valve replacement. The aim of the study was to evaluate the absolute rates of transcatheter aortic valve replacement related PPM implan...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.005028 |
| _version_ | 1818050586705133568 |
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| author | Lennart van Gils Didier Tchetche Thibault Lhermusier Masieh Abawi Nicolas Dumonteil Ramón Rodriguez Olivares Javier Molina‐Martin de Nicolas Pieter R. Stella Didier Carrié Peter P. De Jaegere Nicolas M. Van Mieghem |
| author_facet | Lennart van Gils Didier Tchetche Thibault Lhermusier Masieh Abawi Nicolas Dumonteil Ramón Rodriguez Olivares Javier Molina‐Martin de Nicolas Pieter R. Stella Didier Carrié Peter P. De Jaegere Nicolas M. Van Mieghem |
| author_sort | Lennart van Gils |
| collection | DOAJ |
| description | Background Right bundle branch block is an established predictor for new conduction disturbances and need for a permanent pacemaker (PPM) after transcatheter aortic valve replacement. The aim of the study was to evaluate the absolute rates of transcatheter aortic valve replacement related PPM implantations in patients with pre‐existent right bundle branch block and categorize for different transcatheter heart valves. Methods and Results We pooled data on 306 transcatheter aortic valve replacement patients from 4 high‐volume centers in Europe and selected those with right bundle branch block at baseline without a previously implanted PPM. Logistic regression was used to evaluate whether PPM rate differed among transcatheter heart valves after adjustment for confounders. Mean age was 83±7 years and 63% were male. Median Society of Thoracic Surgeons score was 6.3 (interquartile range, 4.1–10.2). The following transcatheter valve designs were used: Medtronic CoreValve (n=130; Medtronic, Minneapolis, MN); Edwards Sapien XT (ES‐XT; n=124) and Edwards Sapien 3 (ES‐3; n=32; Edwards Lifesciences, Irvine, CA); and Boston Scientific Lotus (n=20; Boston Scientific Corporation, Marlborough, MA). Overall permanent pacemaker implantation rate post‐transcatheter aortic valve replacement was 41%, and per valve design: 75% with Lotus, 46% with CoreValve, 32% with ES‐XT, and 34% with ES‐3. The indication for PPM implantation was total atrioventricular block in 98% of the cases. Lotus was associated with a higher PPM rate than all other valves. PPM rate did not differ between ES‐XT and ES‐3. Ventricular paced rhythm at 30‐day and 1‐year follow‐up was present in 81% at 89%, respectively. Conclusions Right bundle branch block at baseline is associated with a high incidence of PPM implantation for all transcatheter heart valves. PPM rate was highest for Lotus and lowest for ES‐XT and ES‐3. Pacemaker dependency remained high during follow‐up. |
| first_indexed | 2024-12-10T10:55:50Z |
| format | Article |
| id | doaj.art-50ad1823d8cd48ef8c7f80883952150a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-10T10:55:50Z |
| publishDate | 2017-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-50ad1823d8cd48ef8c7f80883952150a2022-12-22T01:51:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-03-016310.1161/JAHA.116.005028Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch BlockLennart van Gils0Didier Tchetche1Thibault Lhermusier2Masieh Abawi3Nicolas Dumonteil4Ramón Rodriguez Olivares5Javier Molina‐Martin de Nicolas6Pieter R. Stella7Didier Carrié8Peter P. De Jaegere9Nicolas M. Van Mieghem10Erasmus Medical Center Rotterdam The NetherlandsClinique Pasteur Toulouse FranceHôpital Rangueil Toulouse FranceUniversity Medical Center Utrecht Utrecht The NetherlandsClinique Pasteur Toulouse FranceUniversity Medical Center Utrecht Utrecht The NetherlandsClinique Pasteur Toulouse FranceUniversity Medical Center Utrecht Utrecht The NetherlandsHôpital Rangueil Toulouse FranceErasmus Medical Center Rotterdam The NetherlandsErasmus Medical Center Rotterdam The NetherlandsBackground Right bundle branch block is an established predictor for new conduction disturbances and need for a permanent pacemaker (PPM) after transcatheter aortic valve replacement. The aim of the study was to evaluate the absolute rates of transcatheter aortic valve replacement related PPM implantations in patients with pre‐existent right bundle branch block and categorize for different transcatheter heart valves. Methods and Results We pooled data on 306 transcatheter aortic valve replacement patients from 4 high‐volume centers in Europe and selected those with right bundle branch block at baseline without a previously implanted PPM. Logistic regression was used to evaluate whether PPM rate differed among transcatheter heart valves after adjustment for confounders. Mean age was 83±7 years and 63% were male. Median Society of Thoracic Surgeons score was 6.3 (interquartile range, 4.1–10.2). The following transcatheter valve designs were used: Medtronic CoreValve (n=130; Medtronic, Minneapolis, MN); Edwards Sapien XT (ES‐XT; n=124) and Edwards Sapien 3 (ES‐3; n=32; Edwards Lifesciences, Irvine, CA); and Boston Scientific Lotus (n=20; Boston Scientific Corporation, Marlborough, MA). Overall permanent pacemaker implantation rate post‐transcatheter aortic valve replacement was 41%, and per valve design: 75% with Lotus, 46% with CoreValve, 32% with ES‐XT, and 34% with ES‐3. The indication for PPM implantation was total atrioventricular block in 98% of the cases. Lotus was associated with a higher PPM rate than all other valves. PPM rate did not differ between ES‐XT and ES‐3. Ventricular paced rhythm at 30‐day and 1‐year follow‐up was present in 81% at 89%, respectively. Conclusions Right bundle branch block at baseline is associated with a high incidence of PPM implantation for all transcatheter heart valves. PPM rate was highest for Lotus and lowest for ES‐XT and ES‐3. Pacemaker dependency remained high during follow‐up.https://www.ahajournals.org/doi/10.1161/JAHA.116.005028aortic stenosisbundle‐branch blockpacemakerpredictorsright bundle branch blocktranscatheter aortic valve implantation |
| spellingShingle | Lennart van Gils Didier Tchetche Thibault Lhermusier Masieh Abawi Nicolas Dumonteil Ramón Rodriguez Olivares Javier Molina‐Martin de Nicolas Pieter R. Stella Didier Carrié Peter P. De Jaegere Nicolas M. Van Mieghem Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic stenosis bundle‐branch block pacemaker predictors right bundle branch block transcatheter aortic valve implantation |
| title | Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block |
| title_full | Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block |
| title_fullStr | Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block |
| title_full_unstemmed | Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block |
| title_short | Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre‐Existent Right Bundle Branch Block |
| title_sort | transcatheter heart valve selection and permanent pacemaker implantation in patients with pre existent right bundle branch block |
| topic | aortic stenosis bundle‐branch block pacemaker predictors right bundle branch block transcatheter aortic valve implantation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.005028 |
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