Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records. Kaplan-Meier plots and Cox regression analysis were performed.

RESULTS: Forty subjects were excluded, leaving 128 patients for final inclusion. 41 (32%) received a PPM (mean age 82 vs. 80 in patients without PPM, p = .06) within 30 days of the TAVI procedure. Median follow-up was ∼4 years and 37 (29%) died. One-year mortality was 14% for non-PPM patients vs. 2% in PPM patients, and mortality at 5yrs 70% vs. 54%, respectively. Kaplan-Meier survival analysis showed higher mortality in patients without PPM (p = .008). In multivariate survival analysis significant variables were: No PPM (HR 2.6; CI 1.1-6.2; p = .03), chronic obstructive pulmonary disease (HR 2.4; CI 1.2-5.0; p = .02) and either pre- or post-procedural chronic or paroxystic atrial fibrillation (HR 2.3; CI 1.2-4.7; p= .02).

CONCLUSION: TAVI-patients with a PPM had better survival than patients in whom a PPM was not implanted.

OriginalsprogEngelsk
TidsskriftScandinavian Cardiovascular Journal
Vol/bind51
Udgave nummer1
Sider (fra-til)40-46
ISSN1401-7431
DOI
StatusUdgivet - jan. 2017

Fingeraftryk

Survival Analysis
Transcatheter Aortic Valve Replacement
Chronic Obstructive Pulmonary Disease
Medical Records
Electrocardiography
Multivariate Analysis
Regression Analysis

Citer dette

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title = "Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement",
abstract = "OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records. Kaplan-Meier plots and Cox regression analysis were performed.RESULTS: Forty subjects were excluded, leaving 128 patients for final inclusion. 41 (32{\%}) received a PPM (mean age 82 vs. 80 in patients without PPM, p = .06) within 30 days of the TAVI procedure. Median follow-up was ∼4 years and 37 (29{\%}) died. One-year mortality was 14{\%} for non-PPM patients vs. 2{\%} in PPM patients, and mortality at 5yrs 70{\%} vs. 54{\%}, respectively. Kaplan-Meier survival analysis showed higher mortality in patients without PPM (p = .008). In multivariate survival analysis significant variables were: No PPM (HR 2.6; CI 1.1-6.2; p = .03), chronic obstructive pulmonary disease (HR 2.4; CI 1.2-5.0; p = .02) and either pre- or post-procedural chronic or paroxystic atrial fibrillation (HR 2.3; CI 1.2-4.7; p= .02).CONCLUSION: TAVI-patients with a PPM had better survival than patients in whom a PPM was not implanted.",
author = "Jonathan Engborg and Casper Riechel-Sarup and Oke Gerke and Hans Mickley and Sandgaard, {Niels Christian} and Henrik Nissen and Diederichsen, {Axel Cosmus Pyndt}",
year = "2017",
month = "1",
doi = "10.1080/14017431.2016.1236982",
language = "English",
volume = "51",
pages = "40--46",
journal = "Scandinavian Cardiovascular Journal",
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Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement. / Engborg, Jonathan; Riechel-Sarup, Casper; Gerke, Oke; Mickley, Hans; Sandgaard, Niels Christian; Nissen, Henrik; Diederichsen, Axel Cosmus Pyndt.

I: Scandinavian Cardiovascular Journal, Bind 51, Nr. 1, 01.2017, s. 40-46.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement

AU - Engborg, Jonathan

AU - Riechel-Sarup, Casper

AU - Gerke, Oke

AU - Mickley, Hans

AU - Sandgaard, Niels Christian

AU - Nissen, Henrik

AU - Diederichsen, Axel Cosmus Pyndt

PY - 2017/1

Y1 - 2017/1

N2 - OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records. Kaplan-Meier plots and Cox regression analysis were performed.RESULTS: Forty subjects were excluded, leaving 128 patients for final inclusion. 41 (32%) received a PPM (mean age 82 vs. 80 in patients without PPM, p = .06) within 30 days of the TAVI procedure. Median follow-up was ∼4 years and 37 (29%) died. One-year mortality was 14% for non-PPM patients vs. 2% in PPM patients, and mortality at 5yrs 70% vs. 54%, respectively. Kaplan-Meier survival analysis showed higher mortality in patients without PPM (p = .008). In multivariate survival analysis significant variables were: No PPM (HR 2.6; CI 1.1-6.2; p = .03), chronic obstructive pulmonary disease (HR 2.4; CI 1.2-5.0; p = .02) and either pre- or post-procedural chronic or paroxystic atrial fibrillation (HR 2.3; CI 1.2-4.7; p= .02).CONCLUSION: TAVI-patients with a PPM had better survival than patients in whom a PPM was not implanted.

AB - OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records. Kaplan-Meier plots and Cox regression analysis were performed.RESULTS: Forty subjects were excluded, leaving 128 patients for final inclusion. 41 (32%) received a PPM (mean age 82 vs. 80 in patients without PPM, p = .06) within 30 days of the TAVI procedure. Median follow-up was ∼4 years and 37 (29%) died. One-year mortality was 14% for non-PPM patients vs. 2% in PPM patients, and mortality at 5yrs 70% vs. 54%, respectively. Kaplan-Meier survival analysis showed higher mortality in patients without PPM (p = .008). In multivariate survival analysis significant variables were: No PPM (HR 2.6; CI 1.1-6.2; p = .03), chronic obstructive pulmonary disease (HR 2.4; CI 1.2-5.0; p = .02) and either pre- or post-procedural chronic or paroxystic atrial fibrillation (HR 2.3; CI 1.2-4.7; p= .02).CONCLUSION: TAVI-patients with a PPM had better survival than patients in whom a PPM was not implanted.

U2 - 10.1080/14017431.2016.1236982

DO - 10.1080/14017431.2016.1236982

M3 - Journal article

C2 - 27624406

VL - 51

SP - 40

EP - 46

JO - Scandinavian Cardiovascular Journal

JF - Scandinavian Cardiovascular Journal

SN - 1401-7431

IS - 1

ER -