Late Outcomes of Permanent Pacemaker Implantation After TAVR: Meta-analysis of Reconstructed Time-to-Event Data
Michel Pompeu Sá, Xander Jacquemyn, Tian Sun, Jef Van den Eynde, Panagiotis Tasoudis, Ozgun Erten, Serge Sicouri, Gianluca Torregrossa, Marie‐Annick Clavel, Philippe Pîbarot, Basel Ramlawi
Abstract
Background: Permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) is relatively frequent, and its impact on outcomes during follow-up remains a matter of discussion. Previous meta-analyses have yielded conflicting results. Methods: To compare late outcomes in patients after TAVR with and without PPI, PubMed/MEDLINE, Embase, and Google Scholar were searched for studies that reported rates of mortality/survival, rehospitalization for heart failure (HF), stroke, and/or endocarditis accompanied by at least 1 Kaplan-Meier curve for any of these outcomes. We adopted a 2-stage approach to reconstruct individual patient data on the basis of the published Kaplan-Meier graphs. Results: = .925) during follow-up. Conclusions: Patients who undergo PPI after TAVR experience higher risk of mortality and HF-related rehospitalization over time. These findings provide support for the implementation of procedural strategies to prevent heart conduction disorder and, thus, avoid PPI at the time of TAVR.