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Novel predictors of permanent pacemaker implantation following transcatheter aortic valve replacement

World Journal of Cardiology 2023年第11期15卷 582-598页

作者： Somto Nwaedozie Haibin Zhang Javad Najjar Mojarrab Param Sharma Paul Yeung Peter Umukoro Deepa Soodi rachel gabor Kelley Anderson Romel Garcia-Montilla Department of Cardiovascular Disease Marshfield ClinicMarshfieldWI 54449United States Hospitalist Medicine Marshfield ClinicMarshfieldWI 54449United States Department of Nephrology Henry Ford Health SystemDetroitMI 48202United States Department of Hospital Medicine Marshfield ClinicMarshfieldWI 54449United States Department of Nephrology Hendricks Regional HealthDanvilleIN 46122United States Clinical Research Center Marshfield ClinicMarshfieldWI 54449United States Department of Trauma Surgery and Surgical Critical Care Marshfield ClinicMarshfieldWI 54449United States

BACKGROUND Conduction and rhythm abnormalities requiring permanent pacemakers(PPM)are short-term complications following transcatheter aortic valve replacement(TAVR),and their clinical outcomes remain *** novel predictors of post-TAVR PPM,like QRS duration,QTc prolongation,and supraventricular arrhythmias,have been poorly *** To evaluate the effects of baseline nonspecific interventricular conduction delay and supraventricular arrhythmia on post-TAVR PPM requirement and determine the impact of PPM implantation on clinical *** RESULTS Out of the 357 patients that met inclusion criteria,the mean age was 80 years,188(52.7%)were male,and 57(16%)had a PPM *** demographics,valve type,and cardiovascular risk factors were similar except for type II diabetes mellitus(DM),which was more prevalent in the PPM cohort(59.6%vs 40.7%;P=0.009).The PPM cohort had a significantly higher rate of pre-procedure right bundle branch block,prolonged QRS>120 ms,prolonged QTc>470 ms,and supraventricular *** was a consistently significant increase in the odds ratio(OR)of PPM implantation for every 20 ms increase in the QRS duration above 100 ms:QRS 101-120[OR:2.44;confidence intervals(CI):1.14-5.25;P=0.022],QRS 121-140(OR:3.25;CI:1.32-7.98;P=0.010),QRS 141-160(OR:6.98;CI:3.10-15.61;P120(aOR:2.18;CI:1.02-4.66;P=0.045)and marginally significant for supraventricular arrhythmias(aOR:1.82;CI:0.97-3.42;P=0.062).The PPM cohort had a higher adjusted OR of heart failure(HF)hospitalization(aOR:2.2;CI:1.1-4.3;P=0.022)and nonfatal myocardial infarction(MI)(aOR:3.9;CI:1.1-14;P=0.031)without any difference in mortality(aOR:1.1;CI:0.5-2.7;P=0.796)at one *** Pre-TAVR type II DM and QRS duration>120,regardless of the presence of bundle branch blocks,are predictors of post-TAVR *** 1-year post-

关键词： Transcatheter aortic valve replacement Balloon-expandable valve Self-expandable valve Myocardial infarction Left bundle-branch block Nonspecific inter-ventricular defect Coronary artery bypass graft Coronary artery disease

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