Long‐term pacemaker dependency and impact of pacing on mortality following transcatheter aortic valve replacement with the LOTUS valve. Issue 4 (4th January 2018)

• Record Type: Journal Article
• Authors: Alasti, Mohammad; Rashid, Hashrul; Rangasamy, Karthikeyan; Kotschet, Emily; Adam, David; Alison, Jeff; Gooley, Robert; Zaman, Sarah
• Is Part Of: Catheterization and cardiovascular interventions. Volume 92:Issue 4(2018)
• Page Start: 777
• Page End: 782
• Publication Date: 2018-01-04
• Subjects: aortic stenosis -- pacemaker dependency -- permanent pacemaker -- transcatheter aortic valve replacement; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.27463
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: 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.