Evidence map›Paper›PMID 41919584›Full record

ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026

Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Incidence, Predictors, and Association With Reduced Ischemic Stroke Risk.

Omar Saleh, Nicholas J Valle, Shinjer Li, Saleh Mostafa, Israa Saleh, Raymond Benza, Deepak R Talreja, Matthew R Summers

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Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Omar SalehDepartment of Internal Medicine, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Eastern Virginia Medical School, Norfolk, Virginia, USA.ORCID 0009-0005-8132-9370
Nicholas J ValleDepartment of Internal Medicine, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Eastern Virginia Medical School, Norfolk, Virginia, USA.ORCID 0009-0000-8820-2050
Shinjer LiEastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, Virginia, USA.
Saleh MostafaDepartment of Cardiology, University of Arizona, Tucson, Arizona, USA.
Israa SalehEastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, Virginia, USA.
Raymond BenzaEastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, Virginia, USA.
Deepak R TalrejaDepartment of Structural Cardiology, Sentara Medical Group, Sentara Health, Virginia Beach, Virginia, USA.
Matthew R SummersDepartment of Structural Cardiology, Sentara Medical Group, Sentara Health, Virginia Beach, Virginia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDevelopment of conduction abnormalities requiring pacing after transcatheter aortic valve replacement (TAVR) is relatively common. The effects of post-TAVR permanent pacemaker (PPM) implantation on mortality, ischemic stroke, and cardiovascular outcomes remain incompletely characterized.

aimsTo evaluate the incidence, predictors, and cardiovascular outcomes of post-TAVR permanent pacemaker implantation, including its association with 1-year ischemic stroke risk.

methodsAdults undergoing TAVR (2008-2019; n = 1101) were evaluated. Patients with prior PPM (n = 104) and/or valve-in-valve or redo TAVR (n = 11) were excluded. PPM placement was identified post-indexed TAVR admission based on procedure codes, including both in-hospital and post-discharge implantations. Primary outcomes included 1-year mortality, major adverse cardiovascular events (MACE), myocardial infarction (MI), and ischemic stroke. Multivariate logistic regression was performed to identify independent predictors of 1-year ischemic stroke.

resultsWithin the TAVR cohort (N = 1101), 158 patients (14.4%) received PPM within 1-year, including 135 (12.3%) in-hospital and 23 post-discharge. PPM was not associated with a significant difference in 1-year mortality (15.8% vs. 14.7%, p = 0.816) or 1-year MACE (20.9% vs. 21.0%, p = 1.000). However, PPM was associated with significantly lower ischemic stroke rate at 1 year (1.3% vs. 4.8%, p = 0.044). In multivariate analysis adjusting for age, sex, and comorbidities, PPM was associated with 77% lower risk of 1-year ischemic stroke (adjusted OR 0.234, 95% CI 0.056-0.977, p = 0.046). Late PPM implantation (> 3 days) was associated with numerically higher 1-year mortality (30.0% vs. 14.3%, p = 0.647) and MACE (36.7% vs. 17.1%, p = 0.119) compared to early implantation, though these outcomes did not reach statistical significance.

conclusionPPM after TAVR was not associated with increased mortality or MACE but was independently associated with significantly lower ischemic stroke risk. Late PPM implantation showed a trend toward worse outcomes. These findings suggest that appropriately indicated PPM may confer cerebrovascular protection, and early implantation when indicated may be preferable. These findings warrant further validation in prospective studies.

Indexed as

Aortic Valve StenosisArrhythmias, CardiacCardiac Pacing, ArtificialIschemic StrokePacemaker, ArtificialTranscatheter Aortic Valve ReplacementAgedAged, 80 and overFemaleHumansIncidenceMaleProtective FactorsRetrospective StudiesRisk AssessmentRisk Factorsatrioventricular blockcardiovascular outcomesconduction abnormalityischemic strokepermanent pacemakertranscatheter aortic valve replacement

Identifiers

PMID41919584
PMCPMC13176699

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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.