TCT-195 In-Hospital and Readmission Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement
Megaly M, Sedhom R, Elbadawi A, Saad M, Cavalcante J, Sengupta J, and Garcia S. TCT-195 In-Hospital and Readmission Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2021; 78(19):B80.
J Am Coll Cardiol
Background: Permanent pacemaker implantation (PPMI) is a known complication of TAVR. It is unclear if recent efforts and procedure advancements have resulted in lower in-hospital PPMI rates or a shift toward outpatient PPMI after the index hospitalization.
Methods: We used the Nationwide Readmissions Database to analyze post-TAVR PPMI rates from 2016 to 2018. All trend analyses were performed using the Poisson regression method. We performed multivariate logistic regression analysis to identify predictors of 30-day readmission for PPMI.
Results: A total of 7,848 records (national estimate of 14,038 records) out of 70,245 TAVR records (national estimate of 126,794 records) (11.1%) underwent PPMI during the index hospitalization. There was a significant trend toward lower PPMI over the study period (12.3% in the first quarter of 2016 to 10.6% in the last quarter of 2018) (P trend < 0.001). 862 patients were readmitted for PPMI (national estimate of 1,602 records, 1.5%). There was no significant change in the trend of patients readmitted for PPMI from 2016 to 2018. Bicuspid aortic valve, history of atrial fibrillation or flutter, morbid obesity, and severe renal disease were independently associated with 30-day readmission for PPMI, while female sex and having the procedure at a teaching hospital were protective against readmission for PPMI.
Conclusion: Over the study period from 2016 to 2018, the overall PPMI rate during the index hospitalization was 11.1% with a decreasing trend, and readmission for PPMI was 1.5% with a stable trend. Important predictors of readmission for PPMI included bicuspid aortic valve, history of atrial fibrillation or flutter, morbid obesity, and severe renal disease.