Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients
Heart block requiring permanent pacemaker (PPM) implantation is a relatively frequent complication of transcatheter aortic valve replacement (TAVR). The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantat...
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| Veröffentlicht in: | Heart rhythm O2 2022-08, Vol.3 (4), p.385-392 |
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| creator | Abu Rmilah, Anan A. Al-Zu’bi, Hossam Haq, Ikram-Ul Yagmour, Asil H. Jaber, Suhaib A. Alkurashi, Adham K. Qaisi, Ibraheem Kowlgi, Gurukripa N. Cha, Yong-Mei Mulpuru, Siva DeSimone, Christopher V. Deshmukh, Abhishek J. |
| description | Heart block requiring permanent pacemaker (PPM) implantation is a relatively frequent complication of transcatheter aortic valve replacement (TAVR).
The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantation post-TAVR.
Medline and EMBASE searches were performed to include all studies reporting PPM post-TAVR between 2015 and 2020. Pertinent data were extracted from the studies for further analysis. RevMan was used to create forest plots and calculate risk ratios (RRs).
We evaluated 41 variables from 239 studies with a total of 981,168 patients. From this cohort, 17.4% received a PPM following TAVR. Strong predictors for PPM implant were right bundle branch block (RBBB) (RR 3.12; P |
| doi_str_mv | 10.1016/j.hroo.2022.05.001 |
| format | Article |
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The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantation post-TAVR.
Medline and EMBASE searches were performed to include all studies reporting PPM post-TAVR between 2015 and 2020. Pertinent data were extracted from the studies for further analysis. RevMan was used to create forest plots and calculate risk ratios (RRs).
We evaluated 41 variables from 239 studies with a total of 981,168 patients. From this cohort, 17.4% received a PPM following TAVR. Strong predictors for PPM implant were right bundle branch block (RBBB) (RR 3.12; P <.001) and bifascicular block (RR 2.40; P = .002). Intermediate factors were chronic kidney disease (CKD) (RR 1.53; P <.0001) and first-degree atrioventricular block (FDAVB) (RR 1.44; P <.001). Weak factors (RR 1–1.50; P <.05) were male gender, age ≥80 years, body mass index ≥25, diabetes mellitus (DM), atrial fibrillation (AF), and left anterior fascicular block (LAFB). These factors along with increased left ventricular outflow tract (LVOT) area (>435 mm2) and/or aortic annulus diameter (>24.4 mm) were incorporated to propose a new scoring system to stratify patients into high- and low-risk groups.
Male gender, age ≥80 years, FDAVB, RBBB, AF, DM, CKD, Medtronic CoreValve, transfemoral TAVR, increased LVOT, and aortic annulus diameter were significant predictors of post-TAVR PPM implantation. Preprocedural assessment should consider these factors to guide clinical decision-making before TAVR. Validation of our scoring system is warranted.</description><identifier>ISSN: 2666-5018</identifier><identifier>EISSN: 2666-5018</identifier><identifier>DOI: 10.1016/j.hroo.2022.05.001</identifier><identifier>PMID: 36097458</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>Atrioventricular block ; Bundle branch block ; Clinical ; Conduction disturbance ; Pacemaker ; Transcatheter aortic valve replacement</subject><ispartof>Heart rhythm O2, 2022-08, Vol.3 (4), p.385-392</ispartof><rights>2022 Heart Rhythm Society</rights><rights>2022 Heart Rhythm Society. Published by Elsevier Inc. 2022 Heart Rhythm Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-b8eadcf03b3a06a693d148a4d6dc78081bfc29ba3dfd59aa233b8b820c71de4f3</citedby><cites>FETCH-LOGICAL-c432t-b8eadcf03b3a06a693d148a4d6dc78081bfc29ba3dfd59aa233b8b820c71de4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463692/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463692/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids></links><search><creatorcontrib>Abu Rmilah, Anan A.</creatorcontrib><creatorcontrib>Al-Zu’bi, Hossam</creatorcontrib><creatorcontrib>Haq, Ikram-Ul</creatorcontrib><creatorcontrib>Yagmour, Asil H.</creatorcontrib><creatorcontrib>Jaber, Suhaib A.</creatorcontrib><creatorcontrib>Alkurashi, Adham K.</creatorcontrib><creatorcontrib>Qaisi, Ibraheem</creatorcontrib><creatorcontrib>Kowlgi, Gurukripa N.</creatorcontrib><creatorcontrib>Cha, Yong-Mei</creatorcontrib><creatorcontrib>Mulpuru, Siva</creatorcontrib><creatorcontrib>DeSimone, Christopher V.</creatorcontrib><creatorcontrib>Deshmukh, Abhishek J.</creatorcontrib><title>Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients</title><title>Heart rhythm O2</title><description>Heart block requiring permanent pacemaker (PPM) implantation is a relatively frequent complication of transcatheter aortic valve replacement (TAVR).
The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantation post-TAVR.
Medline and EMBASE searches were performed to include all studies reporting PPM post-TAVR between 2015 and 2020. Pertinent data were extracted from the studies for further analysis. RevMan was used to create forest plots and calculate risk ratios (RRs).
We evaluated 41 variables from 239 studies with a total of 981,168 patients. From this cohort, 17.4% received a PPM following TAVR. Strong predictors for PPM implant were right bundle branch block (RBBB) (RR 3.12; P <.001) and bifascicular block (RR 2.40; P = .002). Intermediate factors were chronic kidney disease (CKD) (RR 1.53; P <.0001) and first-degree atrioventricular block (FDAVB) (RR 1.44; P <.001). Weak factors (RR 1–1.50; P <.05) were male gender, age ≥80 years, body mass index ≥25, diabetes mellitus (DM), atrial fibrillation (AF), and left anterior fascicular block (LAFB). These factors along with increased left ventricular outflow tract (LVOT) area (>435 mm2) and/or aortic annulus diameter (>24.4 mm) were incorporated to propose a new scoring system to stratify patients into high- and low-risk groups.
Male gender, age ≥80 years, FDAVB, RBBB, AF, DM, CKD, Medtronic CoreValve, transfemoral TAVR, increased LVOT, and aortic annulus diameter were significant predictors of post-TAVR PPM implantation. Preprocedural assessment should consider these factors to guide clinical decision-making before TAVR. Validation of our scoring system is warranted.</description><subject>Atrioventricular block</subject><subject>Bundle branch block</subject><subject>Clinical</subject><subject>Conduction disturbance</subject><subject>Pacemaker</subject><subject>Transcatheter aortic valve replacement</subject><issn>2666-5018</issn><issn>2666-5018</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAYxCNERavSF-DkIweS-k_i2AghVRVQpErlAGfri_2l6yWJg-1d1JfgmevVVgguPdmS5zdjzVTVG0YbRpm83DabGELDKecN7RpK2YvqjEsp644y9fKf-2l1kdKWUso7xnSvX1WnQlLdt506q_58i-i8zX65JyvGGRZcMlnB4gw_MRI_rxMsGbIPCxnDNIXfB2mOsCQLeYO5iCDE7C3Zw7RHErEQBS8-78kVsWHJOK8hQnwgM2aoYYHpIflEwki0Yu-YVCUw-wKk19XJCFPCi6fzvPrx-dP365v69u7L1-ur29q2gud6UAjOjlQMAqgEqYVjrYLWSWd7RRUbRsv1AMKNrtMAXIhBDYpT2zOH7SjOq49H33U3zOhsyY4wmTX6ufzTBPDm_5fFb8x92BvdSiE1LwZvnwxi-LXDlM3sk8WplIVhlwzvWUtlJ7QuUn6U2hhSijj-jWHUHLY0W3PY0hy2NLQzZcsCfThCWFrYe4wm2dKQLWNFtNm44J_DHwEfXKuN</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Abu Rmilah, Anan A.</creator><creator>Al-Zu’bi, Hossam</creator><creator>Haq, Ikram-Ul</creator><creator>Yagmour, Asil H.</creator><creator>Jaber, Suhaib A.</creator><creator>Alkurashi, Adham K.</creator><creator>Qaisi, Ibraheem</creator><creator>Kowlgi, Gurukripa N.</creator><creator>Cha, Yong-Mei</creator><creator>Mulpuru, Siva</creator><creator>DeSimone, Christopher V.</creator><creator>Deshmukh, Abhishek J.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220801</creationdate><title>Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients</title><author>Abu Rmilah, Anan A. ; Al-Zu’bi, Hossam ; Haq, Ikram-Ul ; Yagmour, Asil H. ; Jaber, Suhaib A. ; Alkurashi, Adham K. ; Qaisi, Ibraheem ; Kowlgi, Gurukripa N. ; Cha, Yong-Mei ; Mulpuru, Siva ; DeSimone, Christopher V. ; Deshmukh, Abhishek J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-b8eadcf03b3a06a693d148a4d6dc78081bfc29ba3dfd59aa233b8b820c71de4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Atrioventricular block</topic><topic>Bundle branch block</topic><topic>Clinical</topic><topic>Conduction disturbance</topic><topic>Pacemaker</topic><topic>Transcatheter aortic valve replacement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abu Rmilah, Anan A.</creatorcontrib><creatorcontrib>Al-Zu’bi, Hossam</creatorcontrib><creatorcontrib>Haq, Ikram-Ul</creatorcontrib><creatorcontrib>Yagmour, Asil H.</creatorcontrib><creatorcontrib>Jaber, Suhaib A.</creatorcontrib><creatorcontrib>Alkurashi, Adham K.</creatorcontrib><creatorcontrib>Qaisi, Ibraheem</creatorcontrib><creatorcontrib>Kowlgi, Gurukripa N.</creatorcontrib><creatorcontrib>Cha, Yong-Mei</creatorcontrib><creatorcontrib>Mulpuru, Siva</creatorcontrib><creatorcontrib>DeSimone, Christopher V.</creatorcontrib><creatorcontrib>Deshmukh, Abhishek J.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Heart rhythm O2</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abu Rmilah, Anan A.</au><au>Al-Zu’bi, Hossam</au><au>Haq, Ikram-Ul</au><au>Yagmour, Asil H.</au><au>Jaber, Suhaib A.</au><au>Alkurashi, Adham K.</au><au>Qaisi, Ibraheem</au><au>Kowlgi, Gurukripa N.</au><au>Cha, Yong-Mei</au><au>Mulpuru, Siva</au><au>DeSimone, Christopher V.</au><au>Deshmukh, Abhishek J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients</atitle><jtitle>Heart rhythm O2</jtitle><date>2022-08-01</date><risdate>2022</risdate><volume>3</volume><issue>4</issue><spage>385</spage><epage>392</epage><pages>385-392</pages><issn>2666-5018</issn><eissn>2666-5018</eissn><abstract>Heart block requiring permanent pacemaker (PPM) implantation is a relatively frequent complication of transcatheter aortic valve replacement (TAVR).
The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantation post-TAVR.
Medline and EMBASE searches were performed to include all studies reporting PPM post-TAVR between 2015 and 2020. Pertinent data were extracted from the studies for further analysis. RevMan was used to create forest plots and calculate risk ratios (RRs).
We evaluated 41 variables from 239 studies with a total of 981,168 patients. From this cohort, 17.4% received a PPM following TAVR. Strong predictors for PPM implant were right bundle branch block (RBBB) (RR 3.12; P <.001) and bifascicular block (RR 2.40; P = .002). Intermediate factors were chronic kidney disease (CKD) (RR 1.53; P <.0001) and first-degree atrioventricular block (FDAVB) (RR 1.44; P <.001). Weak factors (RR 1–1.50; P <.05) were male gender, age ≥80 years, body mass index ≥25, diabetes mellitus (DM), atrial fibrillation (AF), and left anterior fascicular block (LAFB). These factors along with increased left ventricular outflow tract (LVOT) area (>435 mm2) and/or aortic annulus diameter (>24.4 mm) were incorporated to propose a new scoring system to stratify patients into high- and low-risk groups.
Male gender, age ≥80 years, FDAVB, RBBB, AF, DM, CKD, Medtronic CoreValve, transfemoral TAVR, increased LVOT, and aortic annulus diameter were significant predictors of post-TAVR PPM implantation. Preprocedural assessment should consider these factors to guide clinical decision-making before TAVR. Validation of our scoring system is warranted.</abstract><pub>Elsevier Inc</pub><pmid>36097458</pmid><doi>10.1016/j.hroo.2022.05.001</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Heart rhythm O2, 2022-08, Vol.3 (4), p.385-392 |
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| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Atrioventricular block Bundle branch block Clinical Conduction disturbance Pacemaker Transcatheter aortic valve replacement |
| title | Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients |
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