The effet of baseline anemia on post transcatheter aortic valve implantation pacemaker dependency

Introduction:

Post transcatheter aortic valve implantation (TAVI) conduction abnormalities may be transient in an appreciable percentage of patients and hence the need for pacemaker(PPM). The aim of our study is to assess laboratory predictors that are associated with an transient pacemaker dependency.

Materials and methods:

Analysis of all consecutive patients who underwent TAVI between 2010 and 2019 in Kaplan Medical Center, Rehovot, Israel. A total of 370 patients underwent TAVI with 82 patients (23.4%) underwent PPM implantation post-TAVI.

Results and discussion:

Out of the 82 patients, only 62 (77%) patients were evaluated at one-year at our pacemaker unit. 49 patients (79%) were not PPM dependent (group 1 ), five patients (8%) were dependent only at one year (group 2) , eight patients (13%) were transiently dependent only at implantation ( group 3) . The patients’ baseline characteristics did not differ significantly between the three groups.

Pre-TAVI hemoglobin levels were significantly lower in group 3 (median 10.65, IQR: 10.35-11.10 vs median 11.60, IQR: 11.00-12.60, P = 0.039 with group 1 and median 12.20, IQR:11.80-13.20, P = 0.019 with group 2).

In our trial, pre-TAVI hemoglobin levels were significantly lower in patients who developed transient CA. Pre-TAVI low hemoglobin levels may be associated with a type of ischemia relative to the normal conduction system in the heart leading to the appearance of transient CA that requires PPM implantation in the immediate period after TAVI. .

Conclusion:

Correction of the anemia pre-TAVI may decrease the rate of transient CA following TAVI and hence, the rate of PPM implantation and the length of hospital stay.