Predictors of Permanent Pacemaker Insertion Following Transcatheter Aortic Valve Replacement With the CoreValve Revalving System Based on Computed Tomography Analysis: An Asian Multicenter Registry Study.

Kim, Won-Jang; Ko, Young-Guk; Han, Seungbong; Kim, Young-Hak; Dy, Timothy C; Posas, Fabio Enrique B; Lee, Michael Kang-Yin; Kim, Hyo-Soo; Hong, Myeong-Ki; Jang, Yangsoo; Grube, Eberhard; Park, Seung-Jung
The Journal of invasive cardiology
2015Jul ; 27 ( 7 ) :334-40.
저자 상세정보
Kim, Won-Jang -
Ko, Young-Guk -
Han, Seungbong -
Kim, Young-Hak -
Dy, Timothy C -
Posas, Fabio Enrique B -
Lee, Michael Kang-Yin -
Kim, Hyo-Soo -
Hong, Myeong-Ki -
Jang, Yangsoo -
Grube, Eberhard -
Park, Seung-Jung -
BACKGROUND: To determine predictive variables for permanent pacemaker (PPM) insertion after transcatheter aortic valve replacement (TAVR) with the CoreValve Revalving System (CRS). METHODS AND

RESULTS: A total of 121 patients with severe aortic stenosis (AS) were recruited from six Asian medical centers between March 2010 and May 2013. Four patients with preexisting PPM were excluded. The mean age of the remaining 117 patients was 81.2 짹 5.1 years. Twenty-three patients (19.7%) required post-TAVR PPM, with a median time-to-insertion of 7 days (interquartile range, 5-13 days). Two variables were identified as independent predictors of PPM: (1) device depth from the non-coronary cusp (NCC) (odds ratio [OR], 1.263; P=.02) determined by aortic root angiography; and (2) the perimeter stretching index (OR, 1.584; P<.001) determined by computed tomography. The predictive cut-off values were as follows: a perimeter stretching index >1.13 (P<.001) and a device depth from the NCC >7.8 mm (P<.001). The diagnostic accuracy of these variables was 93.2% and 71%, respectively. CONCLUSION: Depth of the device from the NCC and the perimeter stretching index are independent predictors of PPM insertion after CRS-TAVR.
aortic stenosis, transcatheter aortic valve replacement, CoreValve, pacemaker

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
The major findings of this study are as follows: (1) in this cohort, 19.7% of patients received a PPM following CRS implantation; (2) multivariate analysis showed that the perimeter stretching index determined by CT and the device depth from the NCC are the best predictors of the need for PPM insertion; and (3) the optimum values of these variables required to prevent PPM insertion are a stretching index of <1.13 and a device depth of <7.8 mm.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03