Specific recommendations for implantation of each prosthesis , taking into consideration the presence of pre-existent conduction abnormalities and anatomical factors , may be needed to reduce the risk of PPI
Aims The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation ( PPI ) after transcatheter aortic valve implantation ( TAVI ) with new-generation prostheses remains debated .
This systematic review analyses the incidence of PPI after TAVI  with new-generation devices and evaluates the electrical , anatomical , and procedural factors associated with PPI .
In addition , the incidence of PPI after  TAVI with early generation prostheses was review ed for comparison .
Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis.
AIMS Data on procedural and clinical outcomes after  transcatheter aortic valve implantation ( TAVI )  with the new-generation self-exp and ing Medtronic Evolut R prosthesis in comparison with its predecessor , the Medtronic CoreValve , are scarce . The aim of this study was to assess the safety and efficacy of the Evolut R device compared with the former-generation CoreValve . METHODS AND RESULTS In a nationwide , prospect i ve , multicentre cohort study , outcomes of consecutive transfemoral TAVI patients treated with the new-generation Medtronic Evolut R ( September 2014 - February 2016 ) and the Medtronic CoreValve ( February 2011 - February 2016 ) were investigated . Events were reported according to VARC-2 and adjudicated by a clinical events committee . During the study period , 317 and 678 consecutive patients underwent TAVI with the Evolut R and the CoreValve bioprosthesis , respectively . Baseline clinical characteristics between the groups were comparable , although Evolut R patients were lower risk according to the STS score ( 4.8±3.4 % vs. 6.9±5.0 % , p<0.001 ) and logistic EuroSCORE ( 17.3±13 % vs. 20.1±13 % , p=0.009 ) . Implantation of the Evolut R was associated with a lower use of predilatation ( 48.1 % vs. 72.4 % , p<0.001 ) , a shorter procedure time ( 67.9±36 min vs. 76.7±42 min , p=0.002 ) , and less contrast dye use during the procedure ( 155.2±98 ml vs. 208.0±117 ml , p<0.001 ) . Post-procedural mean gradient was comparable ( 7.4±4.7 mmHg vs. 7.5±5.0 mmHg ) , as were the 30-day rates of moderate to severe aortic regurgitation ( 8.5 % vs. 10.5 % ) , major vascular ( 9.8 % vs. 10.3 % ) and life-threatening bleeding complications ( 5.4 % vs. 5.3 % ) , disabling stroke ( 1.9 % vs. 1.6 % ) , all-cause mortality ( 3.2 % vs. 3.4 % ) as well as permanent pacemaker implantation ( 22.1 % vs. 23.4 % ) . CONCLUSIONS Thirty-day clinical outcomes were favourable and comparable between the Evolut R and the CoreValve bioprosthesis
Specific recommendations for implantation of each prosthesis , taking into consideration the presence of pre-existent conduction abnormalities and anatomical factors , may be needed to reduce the risk of PPI
Aims The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation ( PPI ) after transcatheter aortic valve implantation ( TAVI ) with new-generation prostheses remains debated .
This systematic review analyses the incidence of PPI after TAVI  with new-generation devices and evaluates the electrical , anatomical , and procedural factors associated with PPI .
In addition , the incidence of PPI after  TAVI with early generation prostheses was review ed for comparison .