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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
MeSH
Aged, 80 and over ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/mortality ; Aortic Valve Stenosis/surgery* ; Cardiac Catheterization* ; Cardiac Pacing, Artificial/methods* ; China/epidemiology ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Valve Prosthesis* ; Humans ; Male ; Prosthesis Design ; Registries* ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Survival Rate/trends ; Tomography, X-Ray Computed/methods* ; Transcatheter Aortic Valve Replacement/methods*
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.
DOI
2015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141000
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