Impact of Pacemaker Implantation After Transcatheter Aortic Valve Replacement on Long-Term Survival in Patients With Bicuspid Aortic Valve

被引：1

作者：

De Felice, Francesco ^{[1
]}

Paolucci, Luca ^{[1
]}

Cesario, Vincenzo ^{[1
]}

Musto, Carmine ^{[1
]}

Nazzaro, Marco Stefano ^{[1
]}

Chin, Diana ^{[1
]}

Stio, Rocco ^{[1
]}

Pennacchi, Mauro ^{[1
]}

Gabrielli, Domenico ^{[1
]}

Fiorina, Claudia ^{[2
]}

Massussi, Mauro ^{[2
]}

Angelillis, Marco ^{[3
]}

Costa, Giulia ^{[3
]}

Bruschi, Giuseppe ^{[4
]}

Fineschi, Massimo ^{[5
]}

Maffeo, Diego ^{[6
]}

Barletta, Marta ^{[7
]}

Regazzoli, Damiano ^{[8
]}

Montorfano, Matteo ^{[9
,10
]}

机构：

[1] Azienda Osped San Camillo Forlanini, Intervent Cardiol Unit, Rome, Italy

[2] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlth, Cardiac Catheterizat Lab & Cardiol, ASST Spedali Civili Brescia, Brescia, Italy

[3] Azienda Osped Univ Pisana, Catheterizat Lab, Pisa, Italy

[4] ASST Grande Osped Metropolitano Niguarda, Milan, Italy

[5] Azienda Osped Univ Senese, Intervent Cardiol UOSA, Siena, Italy

[6] Fdn Poliambulanza, Intervent Cardiol Unit, Brescia, Italy

[7] Policlin San Donato, Clin & Intervent Cardiol Dept, Ist Ricovero & Cura Carattere Sci IRCCS, San Donato Milanese, Milan, Italy

[8] Humanitas Res Hosp, Ist Ricovero & Cura Carattere Sci IRCCS, Rozzano, Italy

[9] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

[10] IRCCS San Raffaele Sci Inst, Intervent Cardiol Unit, Milan, Italy

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2024年 / 210卷

关键词：

transcatheter aortic valve replacement; pacemaker; bicuspid aortic valve disease; OUTCOMES; PREDICTORS; BLOCK;

D O I：

10.1016/j.amjcard.2023.10.018

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Limited data are available about the impact of permanent pacemaker (PPM) implantation on long-term survival in patients with a bicuspid aortic valve (BAV) and severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR). We aimed to evaluate the long-term clinical outcomes of patients with BAV with AS who underwent periprocedural PPM implantation after TAVR with a self-expandable prosthesis. Data from patients with BAV and severe AS who underwent TAVR between April 2009 and January 2022 and followed in the framework of the One Hospital ClinicalService-CoreValve Project were collected. Patients were categorized in 2 groups according to PPM implantation after TAVR ("PPM" group) or not ("no PPM" group). The coprimary end points were all-cause death and a composite of cardiac mortality, rehospitalization because of cardiac causes, stroke, and myocardial infarction. Overall, 106 patients were considered (74 in the "no PPM" group and 32 in the "PPM" group). No statistically significant difference was found between the groups in terms of follow-up and baseline characteristics. Patients in the PPM group were more likely to show baseline conduction abnormalities (p = 0.023). Patients in the PPM group were more often treated with older generation prosthesis than those in the no PPM group (28.1% vs 5.4%, respectively, p = 0.013). At 2 years of follow-up, all-cause death in the no PPM and PPM groups occurred in 20.0% and 10.0% of patients, respectively (hazard ratio 0.37, 95% confidence interval 0.08 to 1.67). Similarly, no difference was evident for the composite end point between the 2 groups (no PPM vs PPM: 8 [14.6%] vs 6 [19.3%], hazard ratio 1.67, 95% CI 0.58 to 4.81). In conclusion, patients with severe AS and BAV treated with TAVR complicated by PPM implantation are not exposed to an increased risk of major adverse events at 2 years of follow-up. (c) 2023 Elsevier Inc. All rights reserved. (Am J Cardiol 2024;210:146-152)

引用

页码：146 / 152

页数：7

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