Conference Proceeding - Restricted Access
Journal of the American College of Cardiology
Background: Prosthetic valve type has been shown to affect conduction abnormalities following transcatheter aortic valve replacement (TAVR). However data on pre-existing cardiac implantable electronic devices (CIED) in TAVR patients has not been reported. We studied the impact of valve type and device type on mortality in those patients. Methods: We retrospectively reviewed patients with pre-existing CIEDs who underwent TAVR in a large hospital between 2012-2020. Valve types included self-expandable (SE) and balloon expandable (BE). For analysis, we grouped all ICD patients (ICD), dual chamber pacemakers (DPM) and single chamber pacemaker (SPM). Results: Of the total 111 patients studied, SPM included 12 (10.8%) patients, DPM 84 (75.7%) and ICD 15 (13.5%). SPM was associated with the highest mortality (HR 2.86, CI: 1.35-6.03, P= 0.0059) vs ICD (HR: 0.82, P= 0.64) vs DPM (HR 1, reference). SPM had the lowest median survival time of 15 months compared to DPM (53m) and ICD (60m), P=0.01 (Figure 1A). Based on valve type, 76 (67.3%) patients comprised the BE group vs 37 (32.7%) in the SE group. No difference in mortality was observed with valve type (BE, HR 1.3532, CI: 0.717- 2.555, P=0.351). Figure 1B Conclusion: Patients with SPM have the highest mortality with TAVR and valve type did not affect mortality in this population.
Manadant L, Shah K, Seeley E, Haines DE, Mehta N. The impact of device type and valve type on mortality in patients with pre-existing cardiac implantable electronic device undergoing transcatheter aortic valve replacement. J Am Coll Cardiol. 2022 Mar 8;79(9 Suppl):923.