RATES of permanent pacemaker implantation (PPI) exceed 20% in patients with aortic regurgitation (AR). A new retrospective multicentre study focused on evaluating the incidence and risk factors for new PPI in patients who have undergone transcatheter aortic valve implantation (TAVI) using the JenaValve Trilogy System (JVTS). This system is currently the only transcatheter heart valve system that is approved for patients with AR.
The study included 141 patients (median age: 81 years; 41% female) who had not undergone PPI previously, and underwent transfemoral TAVI using the JVTS. Researchers performed comparative analyses regarding baseline and procedural parameters between patients who did and did not undergo PPI at discharge. All participants had at least moderate AR, and the median European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 3.6%.
A total of 34 patients required a new PPI at discharge. The independent predictors of PPI were right bundle branch block and pre-existing first-degree atrioventricular block. Anatomical characteristics, such as annular and left ventricular outflow tract perimeters, were not predictive. There was no statistical difference in procedural factors such as valve oversizing and implantation depth between patients who did and did not undergo new PPI.
In conclusion, 24.1% of patients who underwent TAVI with the JVTS required a new PPI. The team did not identify modifiable risk factors, although rates of new PPI were strongly associated with right bundle branch block and pre-existing first-degree atrioventricular block.
Reference
Wienemann H et al. Predictors of pacemaker implantation in aortic regurgitation patients treated with a dedicated transcatheter heart valve. EuroIntervention. 2025;DOI: 10.4244/EIJ-D-24-01117.
