Lees M, MacLeod J, Pozeg Z, et al. - Findings demonstrate a high (>10%) use of permanent pacemaker in transcatheter aortic valve replacement (TAVR). In addition, pacemaker necessity post-TAVR was most strongly predicted by several ECG abnormalities, especially right bundle branch block (RBBB).

• A retrospective analysis of 377 patients who had TAVR and were without a previous pacemaker; of these, 42 (11.1%) needed permanent pacemaker insertion (PPI) post-TAVR.

• In univariate analysis, the factors linked with increased PPI included larger valves (>29cm), renal insufficiency, and ECG abnormalities including RBBB, QRS duration >200ms, and heart rate < 50bpm.

• Post-multivariable analysis, the independent predictive risk factor of PPI was only ECG abnormalities as a combined outcome (OR 5.19).

• All-cause mortality was not significantly impacted by post-TAVI pacemaker insertion.