Evidence map›Paper›PMID 32671716›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2021

Predictors of conduction recovery after permanent pacemaker implantation following transcatheter aortic valve replacement.

Derek Q Phan, Jesse Goitia, Ming-Sum Lee, Nigel Gupta, Vicken Aharonian, Prakash Mansukhani, Naing Moore, Somjot S Brar, Ray Zadegan

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In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Derek Q PhanDepartment of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Jesse GoitiaDepartment of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Ming-Sum LeeDepartment of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Nigel GuptaDivision of Cardiac Electrophysiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Vicken AharonianRegional Cardiac Catheterization Lab, Kaiser Permanente, Los Angeles Medical Center, 4867 Sunset Boulevard, Cardiac Cath Lab, Room 3755, Los Angeles, CA, 90027, USA.
Prakash MansukhaniRegional Cardiac Catheterization Lab, Kaiser Permanente, Los Angeles Medical Center, 4867 Sunset Boulevard, Cardiac Cath Lab, Room 3755, Los Angeles, CA, 90027, USA.
Naing MooreRegional Cardiac Catheterization Lab, Kaiser Permanente, Los Angeles Medical Center, 4867 Sunset Boulevard, Cardiac Cath Lab, Room 3755, Los Angeles, CA, 90027, USA.
Somjot S BrarRegional Cardiac Catheterization Lab, Kaiser Permanente, Los Angeles Medical Center, 4867 Sunset Boulevard, Cardiac Cath Lab, Room 3755, Los Angeles, CA, 90027, USA.
Ray ZadeganRegional Cardiac Catheterization Lab, Kaiser Permanente, Los Angeles Medical Center, 4867 Sunset Boulevard, Cardiac Cath Lab, Room 3755, Los Angeles, CA, 90027, USA. Ray.X.Zadegan@kp.org.
Kaiser Permanente · USLos Angeles Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeConduction disturbances after transcatheter aortic valve replacement (TAVR) requiring pacemaker (PPM) implantation are a known complication and may be reversible. Therefore, we sought to evaluate the incidence and predictors for atrioventricular (AV) conduction recovery after TAVR.

methodsA single-center, retrospective study of patients undergoing PPM implantation for conduction disorders after TAVR between June 2011 and March 2019. Conduction recovery was defined as ≤ 1% ventricular pacing (VP) on follow-up PPM interrogation.

resultsA total of 110 patients (mean age 83.6 ± 6.6 years, 46.8% female) were included. At a median follow-up of 438 days (interquartile range [IQR] 111-760 days), 35 patients (32%) had conduction recovery, with 50% of these occurring within the first 6 months. On multivariate analysis, predictors of conduction recovery include female sex (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.01-6.4, p = 0.048), non-VP/non-complete heart block rhythm immediately post-TAVR (HR 5.2, 95% CI 1.5-18.1, p = 0.011), normal sinus rhythm 7 days post-TAVR (HR 3.9, 95% CI 1.7-9.2, p = 0.002), and smaller valve size (mm) (HR 0.81, 95% CI 0.7-0.996, p = 0.045). Significant narrowing of the QRS and resolution of new-onset left bundle branch block within 1 month post-TAVR occurred in those with conduction recovery on PPM interrogation.

conclusionsOne-third of patients receiving new PPM implantation have conduction recovery after TAVR, with 50% occurring within the first 6 months. Patient gender, valve size, and rhythm on serial ECGs after TAVR can help identify patients that may recover AV conduction. A conservative approach rather than immediate PPM implantation may be considered in these patients.

Indexed as

Aortic Valve StenosisAtrioventricular BlockPacemaker, ArtificialTranscatheter Aortic Valve ReplacementAged, 80 and overAortic ValveCardiac Pacing, ArtificialFemaleHumansMaleRetrospective StudiesRisk FactorsTreatment OutcomeConduction diseaseElectrocardiogramPermanent pacemakerTranscatheter aortic valve replacement

Identifiers

PMID32671716
OpenAlexW3043265875

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.