Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-054
Incidence and Predictors of Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement
By Sunil Kumar Nadar, Mohammad Al-Rawahi, Adil Al-Riyami, Hatim Al-Lawati
Presenter
Sunil Kumar Nadar
Authors
Sunil Kumar Nadar1, Mohammad Al-Rawahi2, Adil Al-Riyami2, Hatim Al-Lawati2
Affiliation
Dudley Group of Hospitals NHS Trust, United Kingdom1, Sultan Qaboos University Hospital, Oman2
View Study Report
TCTAP A-054
Complex TAVR
Incidence and Predictors of Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement
Sunil Kumar Nadar1, Mohammad Al-Rawahi2, Adil Al-Riyami2, Hatim Al-Lawati2
Dudley Group of Hospitals NHS Trust, United Kingdom1, Sultan Qaboos University Hospital, Oman2
Background
Transcatheter aortic valve replacement (TAVR)has become the standard of care for patients with severe aortic stenosis at high risk for surgery. However, it is associated with a high rate of permanentpacemaker (PPM) implantation. TAVR is now being performed in many centresacross the middle-east. There is limited data regarding the outcomes ofpatients undergoing TAVR in this region. The aim of our study was to assess therates of PPM implantation post TAVR at our institution and to study the factorsthat could predict the need for one.
Methods
Thiswas a retrospective study involving all patients undergoing TAVR at our institution over a 5 year period from 2015 to 2020. We included patients who survived the procedure to discharge and those that were followed up for one year post procedure. All clinical data was obtained from theelectronic case notes of the patients who were identified from our cardiologycatheter lab database. Ethical approval was obtained from our Medical ethicscommittee
Results
A total of 153 patients (age: 74.2+8.2 years;Male 82 (53.6%), Female 71 (46.4%)) were enrolled into the study. Of these, 15patients (age 74.3+9.8 years, 46.6%male) had required a permanent pacemakerwithin one year of follow up, giving a pacemaker implantation rate of 9.8%following TAVI in our cohort of patients. Tenof the 15 implants were performed within the first two weeks of the TAVI, withthe median delay after TAVI being 6 days (IQR of 3-90 days). At one month, 2 of the 12 patients who had a pacing check had 0% pacing. At 6 months, this increased to 3 of teh 8 patients who had a pacing check who were not pacing. At one year, 5 of the 8 patients who had a pacing check were not being paced. The factors that predicted therequirement of a pacemaker were pre-existing RBBB (OR 10.9, 95% CI 3.31-36.33,p<0.001), abnormal QRS axis (OR 9.11, 95% CI 2.77-29.91, p<0.001),prolonged QRS duration (OR 3.26 95%CI 1.06-9.92, p=0.03), and any pre-existingconduction abnormality (OR 1.18, 95% CI 1.08-1.29, p=0.01)
Conclusion
The rates of pacemaker implantation post TAVI procedure at our institution are similar to those published in literature. The risk factors for requiring a pacemaker are also similar. However, our data seems to suggest that a sizeable proportion of these patients appear to regain their normal conduction. It might be worthwhile observing patients with conduction abnormalities before implanting a pacemaker.