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Publications

Journal Article Ahead of print

PubMed: 42044716 DOI: 10.1016/j.ijcard.2026.134525

Pacemaker recovery after permanent pacemaker implantation post-transcatheter aortic valve implantation: A sub-study of the LANDMARK trial.

Int J Cardiol

Authors: Akihiro Tobe, Pieter C Smits, Niels van Royen, Ignacio J Amat-Santos, Martin Hudec, Matjaz Bunc, Ben J L Van den Branden, Peep Laanmets, Daniel Unic, Bela Merkely, Renicus S Hermanides, Vlasis Ninios, Marcin Protasiewicz, Benno J W M Rensing, Pedro L Martin, Fausto Feres, Manuel De Sousa Almeida, Eric van Belle, Axel Linke, Alfonso Ielasi, Matteo Montorfano, Mark Webster, Konstantinos Toutouzas, Emmanuel Teiger, Francesco Bedogni, Michiel Voskuil, Manuel Pan, Oskar Angerås, Won-Keun Kim, Jürgen Rothe, Ivica Kristić, Vicente Peral, Scot Garg, Geert A A Versteeg, Mario García Gómez, Tsung-Ying Tsai, Ashokkumar Thakkar, Udita Chandra, Marie-Claude Morice, Yoshinobu Onuma, Andreas Baumbach, Patrick W Serruys

Affiliations

  • CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland.
  • Cardiovascular European Research Center (CERC), Massy, France.
  • Department of Cardiology, Radboud University Hospital, Nijmegen, the Netherlands.
  • Centro de Investigación Biomédica en Red - Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Department of Acute Cardiology, Middle-Slovak Institute of Cardiovascular Diseases, Banska Bystrica, Slovakia.
  • Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
  • Department of Cardiology, Amphia Hospital, Breda, the Netherlands.
  • Department of Invasive Cardiology, North Estonia Medical Centre, Tallinn, Estonia.
  • Department of Cardiac and Transplant Surgery, University Hospital Dubrava, Zagreb, Croatia.
  • Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Department of Cardiology, Isala Hospital, Zwolle, the Netherlands.
  • Department of Cardiology, European Interbalkan Medical Center, Thessaloniki, Greece.
  • Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Department of Non-Procedural Clinical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland.
  • Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands.
  • Department of Interventional Cardiology, University Hospital of Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.
  • Department of Invasive Cardiology, Instituto Dante Pazzanese, São Paulo, Brazil.
  • CHRC, NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal.
  • Department of Interventional Cardiology, Lille University, Lille, France.
  • Department of Internal Medicine and Cardiology, University Clinic, Heart Center Dresden, University of Technology Dresden, Dresden, Germany.
  • Department of Interventional Cardiology, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
  • School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Department of Cardiology, Auckland City Hospital, Auckland, New Zealand.
  • Department of Cardiology, Hippokration Hospital, Athens, Greece.
  • Department of Interventional Cardiology, Henri Mondor University Hospital, Créteil, France.
  • Department of Clinical Cardiology, San Donato Hospital, Milan, Italy.
  • Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Department of Cardiology, University Hospital Reina Sofía, University of Córdoba, IMIBIC, CIBERCV, Córdoba, Spain.
  • Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
  • Department of Cardiology & Angiology, University of Giessen and Marburg, Gießen, Germany; Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany.
  • Department of Cardiology and Angiology, Campus Bad Krozingen, University Heart Center-University of Freiburg, Bad Krozingen, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Department of Cardiology, University Hospital of Split, Split, Croatia.
  • Department of Cardiology University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.
  • Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom; School of Medicine, University of Central Lancashire, Preston, United Kingdom.
  • Department of Clinical Research, Meril Life Sciences Pvt. Ltd, Vapi, India.
  • Cardiovascular European Research Center (CERC), Massy, France; ICPS, Hôpital Privé Jacques Cartier, Massy, France.
  • Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom; Cleveland Clinic, London, United Kingdom.
  • CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland.

Abstract

BACKGROUND

Conduction system disturbances resulting in permanent pacemaker implantation (PPI) are common complications after transcatheter aortic valve implantation (TAVI). In some patients, there is delayed recovery of the conduction system post-procedure. This study aims to report the incidence and predictors of ventricular pacing (VP) rate≦1% at 1 year after TAVI.

METHODS

This is a post-hoc sub-study of the LANDMARK multicentre trial, which randomized 768 patients in a 2:1:1 ratio to the Myval (n = 384) transcatheter heart valve (THV) series or contemporary THVs (Sapien [n = 192] and Evolut [n = 192] series) for the treatment of severe aortic stenosis. Overall, 122 (15.9%) patients underwent PPI within 30 days after TAVI, and 1-year pacemaker follow-up data were retrospectively collected in 99 patients. Pacemaker recovery (PMR) was defined as a VP rate ≦1% at follow-up.

RESULTS

PMR occurred in 18% (18/99) of patients. The PMR group was younger than the non-PMR group (78.6 ± 3.0 vs 81.1 ± 5.1 years, p = 0.045). Implantation depth under the non-coronary cusp did not differ between groups (5.7 ± 3.5 vs 5.8 ± 2.8 mm, p = 0.94). There were no significant differences in PMR rates based on THV type: Myval 25% (11/44), Sapien 19% (5/27), and Evolut 7% (2/28) (p = 0.16). In multivariable logistic regression, atrial fibrillation was associated with lower odds of PMR (odds ratio 0.09, 95% confidence interval 0.00-0.77, p = 0.02.

CONCLUSIONS

At 1 year, conduction system recovery (VP≦1%) was observed in 18% of patients who underwent PPI after TAVI, with no significant difference among the Myval, Sapien and Evolut series. Atrial fibrillation was associated with lower odds of recovery.

MeSH

Recycling, Cardiology, Aortic Valve, Transcatheter Aortic Valve Replacement