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 .
Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery.
OBJECTIVES This study sought to evaluate the safety and efficacy of the CoreValve transcatheter heart valve ( THV ) for the treatment of severe aortic stenosis in patients at extreme risk for surgery . BACKGROUND Untreated severe aortic stenosis is a progressive disease with a poor prognosis . Transcatheter aortic valve replacement ( TAVR ) with a self-exp and ing bioprosthesis is a potentially effective therapy . METHODS We performed a prospect i ve , multicenter , nonr and omized investigation evaluating the safety and efficacy of self-exp and ing TAVR in patients with symptomatic severe aortic stenosis with prohibitive risks for surgery . The primary endpoint was a composite of all-cause mortality or major stroke at 12 months , which was compared with a pre-specified objective performance goal ( OPG ) . RESULTS A total of 41 sites in the United States recruited 506 patients , of whom 489 underwent attempted treatment with the CoreValve THV .  The rate of all-cause mortality or major stroke at 12 months was 26.0 % ( upper 2-sided 95 % confidence bound : 29.9 % ) versus 43.0 % with the OPG ( p < 0.0001 ) . Individual 30-day and 12-month events included all-cause mortality ( 8.4 % and 24.3 % , respectively ) and major stroke ( 2.3 % and 4.3 % , respectively ) . Procedural events at 30 days included life-threatening/disabling bleeding ( 12.7 % ) , major vascular complications ( 8.2 % ) , and need for permanent pacemaker placement ( 21.6 % ) . The frequency of moderate or severe paravalvular aortic regurgitation was lower 12 months after self-exp and ing TAVR ( 4.2 % ) than at discharge ( 10.7 % ; p = 0.004 for paired analysis ) . CONCLUSIONS TAVR with a self-exp and ing bioprosthesis was safe and effective in patients with symptomatic severe aortic stenosis at prohibitive risk for surgical valve replacement . ( Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement ; NCT01240902 )
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 .