Who needs a permanent pacemaker after transcatheter aortic valve implantation?

Introduction: We aimed to identify predictive factors for pacemaker requirement and determine the rate of pacemaker dependency in a single centre patient group.

Methods And Reults: Out of 116 patients, who underwent transcatheter aortic valve implantation at our institution. Absence of atrial fibrillation at time of procedure, pulmonary hypertension, obesity and severity of aortic valve stenosis were predictive for the need of permanent pacemaker implantation after transcatheter aortic valve implantation.

Conclusion: Only persisting periprocedural and early-onset complete heart block were permanent and resulted in patients' pacemaker dependency. Definite predictors of persistence of conduction impairment are yet to be identified. We can predict only pacemaker dependency, but the real need of pacing in our risky patients with softer indications for permanent pacemaker after transcatheter aortic valve implantation cannot be clearly identified, essential in context of improving quality of their lives in avoiding symptomatic bradycardia, which can be intermittent, especially in such a group of elderly patients often with fragile and degenerate conduction system (Tab. 5, Ref. 34).