Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles Catheterization and Cardiovascular Interventions Year : 2018

Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation

Masao Takahashi
Nicolas Badenco
  • Function : Author
Jacques Monteau
  • Function : Author
Estelle Gandjbakhch
Fabrice Extramiana
  • Function : Author
Marina Urena
  • Function : Author
Nicole Karam
  • Function : Author
Eloi Marijon
  • Function : Author
Vincent Algalarrondo
  • Function : Author
Emmanuel Teiger
  • Function : Author

Abstract

Abstract Objectives This study aimed to assess the impact of pacemaker mode programming on clinical outcomes in patients with high‐degree atrioventricular conduction disturbance (AVCD) after transcatheter aortic valve implantation (TAVI). Background Although high‐degree AVCD after TAVI can receive pacemaker, recovery of the AVCD is often observed. Specific pacemaker algorithms (AAI‐DDD mode switch) are available which favor spontaneous atrioventricular conduction. Methods Of 1,621 consecutive multi‐center TAVI patients, 269 (16.4%) received pacemaker. We retrospectively included 91 patients with persistent high‐degree AVCD at hospital discharge. Pacemaker dependency was defined as absence, inadequate intrinsic ventricular rhythm, or ventricular pacing time > 95% on pacemaker interrogation during follow‐up. Comparison of heart failure hospitalization and death between conventional DDD (cDDD) and other modes was examined (AAI‐DDD and VVI). Results During a mean follow‐up duration of 13 months, the pacemaker dependency rate was 52.8%. Patients with cDDD mode (N = 36: 40.0%) had significantly more pacemaker dependency. Multivariate analysis showed that cDDD mode was independently associated with pacemaker dependency (odds ratio = 3.63, P = 0.03). Moreover, cDDD patients had a significant higher incidence of heart failure hospitalization (Hospitalization: cDDD vs. others = 45.4% vs. 18.2%, P = 0.03) and had a higher incidence of mortality (Death: cDDD vs. the others = 27.0% vs. 4.4%, P = 0.06). Conclusions Up to half of patients implanted for high‐degree AVCD after TAVI had conduction recovery. Patients with cDDD programming at hospital discharge had more pacemaker dependency and a worse cardiac prognosis. Thus, pacemaker mode should be systematically set to promote spontaneous atrioventricular conduction in patients with pacemaker implantation after TAVI.
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Dates and versions

hal-04395829 , version 1 (15-01-2024)

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Masao Takahashi, Nicolas Badenco, Jacques Monteau, Estelle Gandjbakhch, Fabrice Extramiana, et al.. Impact of pacemaker mode in patients with atrioventricular conduction disturbance after trans‐catheter aortic valve implantation. Catheterization and Cardiovascular Interventions, 2018, 92 (7), pp.1380-1386. ⟨10.1002/ccd.27594⟩. ⟨hal-04395829⟩

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