Pacemaker After TAVR Reduces Heart Strain

Conduction abnormalities in patients who undergo transcatheter aortic valve replacement (TAVR) and then need a pacemaker can be worrisome. A Pittsburgh PA team looked at how these patients fared.

In a study to be presented at the American College of Cardiology 65th Scientific Sessions & Expo in Chicago, IL, April 2, University of Pittsburgh researchers Matsataka Sugahara and colleagues looked at 389 consecutive TAVR patients and selected those requiring a permanent pacemaker.

They evaluated the patients before TAVR, then at one month and one year after TAVR.

There were 40 patients in the group studied, but two died and three had upgrades to CRT.

Of the remaining 35 patients, 20 still needed the pacemaker at one year and 15 had recovery of conduction.

Pacemaker dependent patients more frequently had a right bundle branch block prior to TAVR. There was a significant difference in global longitudinal strain over time in the pacemaker dependent patients. These patients showed a steady decline in GLS.

"Conduction abnormalities after TAVR requiring a pacemaker are uncommon but important," the team concluded. The good news is that "Pacemaker dependency after TAVR was associated with a significant decrease in myocardial strain over time."