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D-PO01-235 - Permanent Pacemaker Implantation In Patients Receiving Self-expandable Versus Balloon-expandable Transcatheter Aortic Valve Replacement (ID 157)

 R. Chaudhary: Nothing relevant to disclose.


Background: Transcatheter aortic valve replacement (TAVR) is the preferred treatment option for older patients with symptomatic severe aortic stenosis. Differences in the properties of available TAVR systems affects permanent pacemaker implantation rates.
Objective: To evaluate permanent pacemaker (PPM) implantation rates in patients undergoing balloon-expandable versus self-expandable TAVR.
Methods: A comprehensive literature search in PubMed, Google Scholar and Cochrane Review from inception to November 10, 2019 was performed. Studies (both randomized and non-randomized) reporting PPM implantation rates comparing balloon-expandable vs. self-expandable TAVR were included. Mantel-Haenszel risk ratio (RR) random effects model was used to summarize data between the two groups. Heterogeneity was assessed using I2 statistics.
Results: We included a total of 14,236 patients (7,147 in balloon-expandable arm and 7,089 in self-expandable arm) enrolled in 17 clinical trials. Mean age was 81.84 ± 0.87 years. There was a statistically significant reduction in PPM implantation rates in patients undergoing balloon expandable TAVR (n = 660; 9.2%) as compared to self-expandable TAVR (n = 1,350; 19%) (RR 0.58, 95% CI 0.43-0.78, p<0.001; I2 85.6%). Number needed to harm was 10.
Conclusion: Balloon-expandable TAVR was associated with a significantly lower PPM implantation rates when compared with self-expandable TAVR valve.