Indications and predictors for pacemaker implantation after isolated aortic valve replacement with bioprostheses : the CAREAVR study

Show simple item record Salmi, Samuli J. Nieminen, Tuomo Hartikainen, Juha Biancari, Fausto Lehto, Joonas Nissinen, Maunu Malmberg, Markus Yannopoulos, Fredrik Savolainen, Jyri Airaksinen, Juhani Kiviniemi, Tuomas 2021-08-03T22:44:57Z 2021-12-18T03:45:57Z 2020-09
dc.identifier.citation 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 .
dc.identifier.other PURE: 156352393
dc.identifier.other PURE UUID: 8cb75d09-fe99-4fe6-99fb-d47cfb7766fa
dc.identifier.other WOS: 000584493100016
dc.identifier.other ORCID: /0000-0003-1755-1688/work/84258761
dc.description.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. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Interactive cardiovascular and thoracic surgery.
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Aortic valve replacement
dc.subject Conduction impairment
dc.subject Permanent pacemaker implantation
dc.subject Risk factor
dc.subject RISK-FACTORS
dc.subject LONG-TERM
dc.subject SEPTAL-DEFECT
dc.subject ARRHYTHMIAS
dc.subject SURGERY
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Indications and predictors for pacemaker implantation after isolated aortic valve replacement with bioprostheses : the CAREAVR study en
dc.type Article
dc.contributor.organization HUS Internal Medicine and Rehabilitation
dc.contributor.organization Clinicum
dc.contributor.organization Department of Medicine
dc.contributor.organization University of Helsinki
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization South Carelia Social and Health care District Eksote
dc.contributor.organization HYKS erva
dc.contributor.organization Päijät-Häme Welfare Consortium
dc.contributor.organization HUS Heart and Lung Center
dc.description.reviewstatus Peer reviewed
dc.relation.issn 1569-9293
dc.rights.accesslevel openAccess
dc.type.version acceptedVersion

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