Cardiovascular Implantable Electronic Devices -> Bradycardia Devices: -> Indications D-PO03 - Poster Session III (ID 48) Poster

D-PO03-082 - Prospective Validation Of Risk Prediction Model For Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement In Single High Volume Center Experience (ID 1096)


Background: High-grade atrioventricular block (AVB) requiring cardiac implantable electronic device (CIED) implantation remains a significant sequelae following transcatheter aortic valve replacement (TAVR). Last year, we reported a risk prediction model of CIED implantation after TAVR using consecutive 1071 patients who underwent TAVR from March 2011 to October 2018. This model was presented in HRS 2019 Scientific Sessions. Our model included pre-existing first-degree AVB (1 point), self-expanding valve (1 point), hypertension (1 point), and pre-existing right bundle branch block (RBBB) (2 points). Patients were stratified based on total points (0-5). However, there was no prospective validation of the suggested model.
Objective: The aim of this study was to perform a prospective validation of the suggested model.
Methods: This is a single center, prospective validation study of consecutive patients who underwent TAVR between November 2018 and November 2019. The new cohort did not include any patients who were enrolled in the previous study.
Results: Out of 316 patients who underwent TAVR during the study period, 270 cases were included after excluding pre-existing CIED before TAVR and 38 (14.1%) required new CIED. The prospective validation of our model showed a similar distribution of subgroup to our previous retrospective study (Figure A and B). This model retained a high diagnostic accuracy as ROC area under curve: 0.808 (95% confidence interval 0.74-0.88) and an linear regression in calibration plot (R2 0.778).
Conclusion: Our suggested model accurately predicted the risk of CIED implantation after TAVR. Multi-center prospective validation should be undertaken.