Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population
Background: Permanent pacemaker (PPM) implantation is the main complication of transcatheter aortic valve replacement (TAVR). Few studies have evaluated the requirement for PPM implantation due to ECG changes following TAVR in a Chinese population.Objective: Our study aimed to evaluate the incidence...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.743257/full |
| _version_ | 1818965634020540416 |
|---|---|
| author | Jiaqi Zhang Jiaqi Zhang Chengwei Chi Simiao Tian Shulong Zhang Jihong Liu |
| author_facet | Jiaqi Zhang Jiaqi Zhang Chengwei Chi Simiao Tian Shulong Zhang Jihong Liu |
| author_sort | Jiaqi Zhang |
| collection | DOAJ |
| description | Background: Permanent pacemaker (PPM) implantation is the main complication of transcatheter aortic valve replacement (TAVR). Few studies have evaluated the requirement for PPM implantation due to ECG changes following TAVR in a Chinese population.Objective: Our study aimed to evaluate the incidence and predictors of PPM implantation in a cohort of Chinese patients with TAVR.Methods: We retrospectively evaluated 39 consecutive patients with severe native aortic stenosis referred for TAVR with a self-expandable prosthesis, the Venus A valve (Venus MedTech Inc., Hangzhou, China), from 2019 to 2021 at the Heart Center of Affiliated Zhongshan Hospital of Dalian University. Predictors of PPM implantation were identified using logistic regression.Results: In our study, the incidence of PPM implantation was 20.5%. PPM implantation occurs with higher risk in patients with negative creatinine clearance (CrCl), dyslipidemia, high Society of Thoracic Surgeons (STS) Morbimortality scores, and lead I T wave elevation. TAVR induced several cardiac electrical changes such as increased R wave and T wave changes in lead V5. The main independent predictors of PPM implantation were new-onset left bundle branch block (LBBB) (coef: 3.211, 95% CI: 0.899–7.467, p = 0.004) and lead I T wave elevation (coef: 11.081, 95% CI: 1.632–28.083, p = 0.016).Conclusion: New-onset LBBB and lead I T wave elevation were the main independent predictors of PPM implantation in patients undergoing TAVR. Clinical indications such as negative CrCl, dyslipidemia, high STS Morbimortality scores, and an increased T wave elevation before TAVR should be treated with caution to decrease the need for subsequent PPM implantation. |
| first_indexed | 2024-12-20T13:20:07Z |
| format | Article |
| id | doaj.art-9598952bdfa3415fbd53d49972ef74f7 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-20T13:20:07Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-9598952bdfa3415fbd53d49972ef74f72022-12-21T19:39:25ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-01-01810.3389/fcvm.2021.743257743257Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese PopulationJiaqi Zhang0Jiaqi Zhang1Chengwei Chi2Simiao Tian3Shulong Zhang4Jihong Liu5School of Graduate Studies, Dalian Medical University, Dalian, ChinaHeart Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaHeart Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaDepartment of Scientific Research, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaHeart Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaHeart Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, ChinaBackground: Permanent pacemaker (PPM) implantation is the main complication of transcatheter aortic valve replacement (TAVR). Few studies have evaluated the requirement for PPM implantation due to ECG changes following TAVR in a Chinese population.Objective: Our study aimed to evaluate the incidence and predictors of PPM implantation in a cohort of Chinese patients with TAVR.Methods: We retrospectively evaluated 39 consecutive patients with severe native aortic stenosis referred for TAVR with a self-expandable prosthesis, the Venus A valve (Venus MedTech Inc., Hangzhou, China), from 2019 to 2021 at the Heart Center of Affiliated Zhongshan Hospital of Dalian University. Predictors of PPM implantation were identified using logistic regression.Results: In our study, the incidence of PPM implantation was 20.5%. PPM implantation occurs with higher risk in patients with negative creatinine clearance (CrCl), dyslipidemia, high Society of Thoracic Surgeons (STS) Morbimortality scores, and lead I T wave elevation. TAVR induced several cardiac electrical changes such as increased R wave and T wave changes in lead V5. The main independent predictors of PPM implantation were new-onset left bundle branch block (LBBB) (coef: 3.211, 95% CI: 0.899–7.467, p = 0.004) and lead I T wave elevation (coef: 11.081, 95% CI: 1.632–28.083, p = 0.016).Conclusion: New-onset LBBB and lead I T wave elevation were the main independent predictors of PPM implantation in patients undergoing TAVR. Clinical indications such as negative CrCl, dyslipidemia, high STS Morbimortality scores, and an increased T wave elevation before TAVR should be treated with caution to decrease the need for subsequent PPM implantation.https://www.frontiersin.org/articles/10.3389/fcvm.2021.743257/fullaortic stenosistranscatheter aortic valve replacementcomplete atrioventricular blockpermanent pacemakerpredictors |
| spellingShingle | Jiaqi Zhang Jiaqi Zhang Chengwei Chi Simiao Tian Shulong Zhang Jihong Liu Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population Frontiers in Cardiovascular Medicine aortic stenosis transcatheter aortic valve replacement complete atrioventricular block permanent pacemaker predictors |
| title | Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population |
| title_full | Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population |
| title_fullStr | Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population |
| title_full_unstemmed | Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population |
| title_short | Predictors of Permanent Pacemaker Implantation in Patients After Transcatheter Aortic Valve Replacement in a Chinese Population |
| title_sort | predictors of permanent pacemaker implantation in patients after transcatheter aortic valve replacement in a chinese population |
| topic | aortic stenosis transcatheter aortic valve replacement complete atrioventricular block permanent pacemaker predictors |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.743257/full |
| work_keys_str_mv | AT jiaqizhang predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation AT jiaqizhang predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation AT chengweichi predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation AT simiaotian predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation AT shulongzhang predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation AT jihongliu predictorsofpermanentpacemakerimplantationinpatientsaftertranscatheteraorticvalvereplacementinachinesepopulation |