Salmi , S J , Nieminen , T , Hartikainen , J , Biancari , F , Lehto , J , Nissinen , M , Malmberg , M , Yannopoulos , F , Savolainen , J , Airaksinen , J & Kiviniemi , T 2020 , ' Indications and predictors for pacemaker implantation after isolated aortic valve replacement with bioprostheses : the CAREAVR study ' , Interactive cardiovascular and thoracic surgery. , vol. 31 , no. 3 , pp. 398-404 . https://doi.org/10.1093/icvts/ivaa119
Title: | Indications and predictors for pacemaker implantation after isolated aortic valve replacement with bioprostheses : the CAREAVR study |
Author: | Salmi, Samuli J.; Nieminen, Tuomo; Hartikainen, Juha; Biancari, Fausto; Lehto, Joonas; Nissinen, Maunu; Malmberg, Markus; Yannopoulos, Fredrik; Savolainen, Jyri; Airaksinen, Juhani; Kiviniemi, Tuomas |
Contributor organization: | HUS Internal Medicine and Rehabilitation Clinicum Department of Medicine University of Helsinki Helsinki University Hospital Area South Carelia Social and Health care District Eksote HYKS erva Päijät-Häme Welfare Consortium HUS Heart and Lung Center |
Date: | 2020-09 |
Language: | eng |
Number of pages: | 7 |
Belongs to series: | Interactive cardiovascular and thoracic surgery. |
ISSN: | 1569-9293 |
DOI: | https://doi.org/10.1093/icvts/ivaa119 |
URI: | http://hdl.handle.net/10138/332812 |
Abstract: | OBJECTIVES: We sought to study the indications, long-term occurrence, and predictors of permanent pacemaker implantation (PPI) after isolated surgical aortic valve replacement with bioprostheses. METHODS: The CAREAVR study included 704 patients (385 females, 54.7%) without a preoperative PPI (mean +/- standard deviation age 75 +/- 7years) undergoing isolated surgical aortic valve replacement at 4 Finnish hospitals between 2002 and 2014. Data were extracted from electronic patient records. RESULTS: The follow-up was median 4.7years (range 1day to 12.3years). Altogether 56 patients received PPI postoperatively, with the median 507days from the operation (range 6days to 10.0years). The PPI indications were atrioventricular block (31 patients, 55%) and sick sinus syndrome (21 patients, 37.5%). For 4 patients, the PPI indication remained unknown. A competing risks regression analysis (Fine-Gray method), adjusted with age, sex, diabetes, coronary artery disease, preoperative atrial fibrillation (AF), left ventricular ejection fraction, New York Heart Association class, AF at discharge and urgency of operation, was used to assess risk factors for PPI. Only AF at discharge (subdistribution hazard ratio 4.34, 95% confidence interval 2.34-8.03) was a predictor for a PPI. CONCLUSIONS: Though atrioventricular block is the major indication for PPI after surgical aortic valve replacement, >30% of PPIs are implanted due to sick sinus syndrome during both short-term follow-up and long-term follow-up. Postoperative AF versus sinus rhythm conveys >4-fold risk of PPI. |
Subject: |
Aortic valve replacement
Conduction impairment Permanent pacemaker implantation Risk factor PERMANENT PACEMAKER RISK-FACTORS LONG-TERM CONDUCTION DISORDERS SEPTAL-DEFECT ARRHYTHMIAS SURGERY 3126 Surgery, anesthesiology, intensive care, radiology |
Peer reviewed: | Yes |
Usage restriction: | openAccess |
Self-archived version: | acceptedVersion |
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