OBJECTIVES: To determine permanent pacemaker (PPM) dependency following transcatheter aortic valve replacement (TAVR) with the Lotus™ valve system (Boston Scientific), and the impact of PPM implantation on long-term morbidity and mortality. BACKGROUND: Conduction abnormalities are among the most common complications following TAVR. Limited studies have assessed pacing dependency following TAVR. METHODS: Consecutive patients (n = 166) with severe aortic stenosis who underwent TAVR with the Lotus valve system were prospectively recruited from a single-center. PPMs were implanted according to standard clinical criteria. Patients were followed in-hospital and at 1, 3, 6, and 12 months to determine pacemaker dependency and clinical outcomes. RESULTS: Fourteen patients with a pre-existing PPM (8%) were excluded with the remaining 152 patients aged 83.6 ± 5.6 years and 46% male. PPMs were implanted 3.8 ± 4 days post-TAVR in 38/152 patients (25%). Indication for PPM was complete heart block in 29 (76%) of patients. At 30-day and one-year follow up, 57% and 38% of patients were pacemaker dependent, respectively. The mean ventricular pacing percentage decreased in the first three months after PPM implantation and remained relatively stable after that. CONCLUSION: Only 38% of Lotus recipients who require a PPM following TAVR with the Lotus valve remain pacing dependent at one year.
OBJECTIVES: To determine permanent pacemaker (PPM) dependency following transcatheter aortic valve replacement (TAVR) with the Lotus™ valve system (Boston Scientific), and the impact of PPM implantation on long-term morbidity and mortality. BACKGROUND:Conduction abnormalities are among the most common complications following TAVR. Limited studies have assessed pacing dependency following TAVR. METHODS: Consecutive patients (n = 166) with severe aortic stenosis who underwent TAVR with the Lotus valve system were prospectively recruited from a single-center. PPMs were implanted according to standard clinical criteria. Patients were followed in-hospital and at 1, 3, 6, and 12 months to determine pacemaker dependency and clinical outcomes. RESULTS: Fourteen patients with a pre-existing PPM (8%) were excluded with the remaining 152 patients aged 83.6 ± 5.6 years and 46% male. PPMs were implanted 3.8 ± 4 days post-TAVR in 38/152 patients (25%). Indication for PPM was complete heart block in 29 (76%) of patients. At 30-day and one-year follow up, 57% and 38% of patients were pacemaker dependent, respectively. The mean ventricular pacing percentage decreased in the first three months after PPM implantation and remained relatively stable after that. CONCLUSION: Only 38% of Lotus recipients who require a PPM following TAVR with the Lotus valve remain pacing dependent at one year.
Authors: Christopher U Meduri; Dean J Kereiakes; Vivek Rajagopal; Raj R Makkar; Daniel O'Hair; Axel Linke; Ron Waksman; Vasilis Babliaros; Robert C Stoler; Gregory J Mishkel; David G Rizik; Vijay S Iyer; John Schindler; Dominic J Allocco; Ian T Meredith; Ted E Feldman; Michael J Reardon Journal: J Am Heart Assoc Date: 2019-10-23 Impact factor: 5.501
Authors: Justine M Ravaux; Michele Di Mauro; Kevin Vernooy; Arnoud W Van't Hof; Leo Veenstra; Suzanne Kats; Jos G Maessen; Roberto Lorusso Journal: JTCVS Open Date: 2021-02-12
Authors: Mirosław Gozdek; Jakub Ratajczak; Adam Arndt; Kamil Zieliński; Michał Pasierski; Matteo Matteucci; Dario Fina; Federica Jiritano; Paolo Meani; Giuseppe Maria Raffa; Pietro Giorgio Malvindi; Michele Pilato; Domenico Paparella; Artur Słomka; Uri Landes; Ran Kornowski; Jacek Kubica; Roberto Lorusso; Piotr Suwalski; Mariusz Kowalewski Journal: J Thorac Dis Date: 2020-03 Impact factor: 3.005