B-PO05-056 PACING TRENDS IN PATIENTS IMPLANTED WITH PERMANENT PACEMAKERS FOLLOWING TRANSCATHETER AORTIC VALVE REPLACEMENT

Abstract

Conduction disturbances are a known adverse outcome of transcatheter aortic valve replacement (TAVR). While clinicians are gaining experience in handling these conduction disturbances, little is known about the specific pacing needs and conduction recovery following TAVR. We sought to characterize the pacing trajectories of patients implanted with permanent pacemakers post-TAVR and identify patients with negligible pacing burden at various timepoints. Patients receiving a permanent pacemaker within 7 days post-TAVR were identified from the Optum® de-identified Electronic Health Record dataset of a cohort of patients with or at risk of cardiovascular disease (2007-2019). The data were queried to determine device programming and daily pacing burden. Only dual-chamber devices programmed to a mode that minimizes ventricular pacing were included. We identified 964 patients that received a Medtronic permanent pacemaker within 7 days post-TAVR in the dataset. Of these, 109 had a device with ≥2 daily ventricular pacing measurements while programmed to Managed Ventricular Pacing over the available follow-up. 83% of devices had a lower rate of 60 bpm for the majority of follow-up. On and after 30 days post-TAVR, 28.2% of devices showed ≤1% pacing daily; on and after 90 days, 30.9% showed ≤1% pacing; on and after 1 year, 44.0% showed ≤1% pacing (see Figure). These results suggest that a significant proportion of patients that are indicated for and receive a permanent pacemaker due to TAVR-related conduction disturbances have a negligible pacing burden post-TAVR, and thus would benefit from re-evaluation of long-term pacing need.