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Predictors of Permanent Pacemaker Insertion Following Transcatheter Aortic Valve Replacement With the CoreValve Revalving System Based on Computed Tomography Analysis: An Asian Multicenter Registry Study

Authors
 Kim WJ  ;  Ko YG  ;  Han S  ;  Kim YH  ;  Dy TC  ;  Posas FE  ;  Lee MK  ;  Kim HS  ;  Hong MK  ;  Jang Y  ;  Grube E  ;  Park SJ 
Citation
 Journal of Invasive Cardiology, Vol.27(7) : 334-340, 2015 
Journal Title
 Journal of Invasive Cardiology 
ISSN
 1042-3931 
Issue Date
2015
Abstract
BACKGROUND: To determine predictive variables for permanent pacemaker (PPM) insertion after transcatheter aortic valve replacement (TAVR) with the CoreValve Revalving System (CRS). METHODS AND RESULTS: A total of 121 patients with severe aortic stenosis (AS) were recruited from six Asian medical centers between March 2010 and May 2013. Four patients with preexisting PPM were excluded. The mean age of the remaining 117 patients was 81.2 ± 5.1 years. Twenty-three patients (19.7%) required post-TAVR PPM, with a median time-to-insertion of 7 days (interquartile range, 5-13 days). Two variables were identified as independent predictors of PPM: (1) device depth from the non-coronary cusp (NCC) (odds ratio [OR], 1.263; P=.02) determined by aortic root angiography; and (2) the perimeter stretching index (OR, 1.584; P<.001) determined by computed tomography. The predictive cut-off values were as follows: a perimeter stretching index >1.13 (P<.001) and a device depth from the NCC >7.8 mm (P<.001). The diagnostic accuracy of these variables was 93.2% and 71%, respectively. CONCLUSION: Depth of the device from the NCC and the perimeter stretching index are independent predictors of PPM insertion after CRS-TAVR.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141000
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ; 장양수(Jang, Yang Soo) ; 홍명기(Hong, Myeong Ki)
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