Incidence and Predictors of Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Two-centre experience from Oman .
Al Rawahi, Mohamed N Al Kindi, Adil Al Yarubi, Ahmed Shams, Ahmed Al Riyami, Adil Al Lawati, Hatim El Said, Ahmed Al Riyami, Mohamed Al Saidi, Khalid Al Abri, Ismail
Al Rawahi, Mohamed N
Al Kindi, Adil
Al Yarubi, Ahmed
Shams, Ahmed
Al Riyami, Adil
Al Lawati, Hatim
El Said, Ahmed
Al Riyami, Mohamed
Al Saidi, Khalid
Al Abri, Ismail
Abstract
Objectives: This study aims to evaluate the predictors and rate of permanent pacemaker (PPM) implantation among patients undergoing transcatheter aortic valve replacement (TAVR) at two institutions in Oman. TAVR has become the standard of care for patients with severe aortic stenosis at high risk for surgery. However, it is associated with a high PPM implantation rate. Methods: This was a retrospective study involving all patients undergoing TAVR at two leading cardiac centres in Oman over seven years, from May 2013 to September 2020. We included patients who survived the procedure to discharge and those who were followed-up for at least 1 year post-procedure. Results: A total of 153 patients (mean age = 74.2 � 8.2 years; 82 males [53.6%]) were enrolled in the study. Of these, 15 patients (age = 74.3 � 9.8 years, 46.6% male) required a permanent pacemaker within 1 year of follow-up, giving a pacemaker implantation rate of 9.8% following TAVR in the cohort. The factors that predicted the requirement of a pacemaker were pre-existing right bundle branch block (odds ratio [OR] = 10.9, 95% confidence interval [CI]: 3.31-36.33; P < 0.001); abnormal QRS axis (OR = 9.11, 95% CI: 2.77-29.91; P < 0.001); prolonged QRS duration (OR = 3.26, 95% CI: 1.06-9.92; P = 0.03); and any pre-existing conduction abnormality (OR = 1.18, 95% CI: 1.08-1.29; P = 0.01).
Conclusions: The PPM implantation rates post-TAVR at two Omani institutions are comparable to those reported in the literature. Close rhythm surveillance is crucial, especially in patients with any of the predictors identified above, for the timely identification of susceptible patients who might require PPM implantation.
MIDER Authors
Affiliations
Sultan Qaboos University Hospital; National Heart Centre Muscat; The Dudley Group NHS Foundation Trust
Date
2025/05/02
Type
Collections
Citation
Al Rawahi MN, Al Kindi A, Al Yarubi A, Shams A, Al Riyami A, Al Lawati H, El Said A, Al Riyami M, Al Saidi K, Al Abri I, Al Rawahi N, Al Ismaili A, Al Kindi F, Sadiq MA, Nadar SK. Incidence and Predictors of Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Two-centre experience from Oman. Sultan Qaboos Univ Med J. 2025 May 2;25(1):209-217. doi: 10.18295/2075-0528.2831