Permanent pacemaker reduction using temporary-permanent pacemaker as a 1-month bridge after transcatheter aortic valve replacement: a prospective, multicentre, single-arm, observational study

作者：Sanshuai Chang, Zhengming Jiang, Xinmin Liu, Yi‐Da Tang, Ming Bai, Jizhe Xu, Haiping Wang, Yuguo Chen, Chuanbao Li, Yundai Chen, Changfu Liu, Jianzeng Dong, Jianfang Luo, Jie Li, Guosheng Fu, Sheng Wang, Hui Huang, Yuewu Zhao, Xi-Jin Zhuang, Hasan Jilaihawi, Nicolò Piazza, Feicheng Yu, Thomas Modine, Guangyuan Song · 发表于：EClinicalMedicine · 年份：2024 · DOI：10.1016/j.eclinm.2024.102603 · 被引用次数：13 · 研究领域：Cardiac Valve Diseases and Treatments、Cardiovascular Function and Risk Factors、Pulmonary Hypertension Research and Treatments

Background: The permanent pacemaker (PPM) implantation and pacemaker dependency rates after transcatheter aortic valve replacement (TAVR) are highly variable as some of the conduction disturbances are reversible. It remains poorly investigated how to optimise temporary pacing in these patients. This study aimed to explore the potential reduction in the PPM implantation rate using temporary-permanent pacemaker (TPPM) as a 1-month bridge. Methods: This is a prospective, multicentre, single-arm, observational study. Consecutive patients undergoing TAVR from March 1, 2022 to March 1, 2023 in 13 tertiary hospitals in China were screened. Patients who developed high-degree atrioventricular block, complete heart block, or first-degree atrioventricular block plus new onset left bundle branch block during the TAVR procedure or within 1 month after TAVR were included to receive TPPM. Patients with pre-existing PPM implantation or indications for PPM implantation before the TAVR procedure were excluded. Patients with TPPM were monitored to determine whether the conduction disturbances persisted or recovered. The primary endpoint was the rate of freedom from indications for PPM implantation 1 month after TAVR. This study is registered with ChiCTR, ChiCTR2200057931. Findings: Of 688 patients who have undergone TAVR, 71 developed conduction disturbance and met the inclusion criteria, 1 patient withdrew due to noncompliance, 70 patients received TPPM and completed follow-up. There were 41 (...