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 the Repositionable LOTUS Valve: United Kingdom Experience.
OBJECTIVES This study sought to present the U.K. experience to date with the second-generation LOTUS bioprosthesis ( Boston Scientific , Natick , Massachusetts ) . BACKGROUND First-generation transcatheter aortic valves have limitations . Second-generation repositionable valves may improve on some of those limitations . METHODS Prospect ively collected data relating to procedural and in-hospital outcome was analyzed from 10 implantation centers in the United Kingdom . RESULTS Implants in 228 patients age 81.4 ± 7.6 years were studied ; 53.5 % were male . Mean logistic EuroScore was 17.5 ± 12.4 . One hundred eighty-seven ( 82.0 % ) were undertaken for aortic stenosis , 7 ( 3.1 % ) for aortic regurgitation , and 34 ( 14.9 % ) for mixed aortic valve disease . A total of 67.1 % of cases were done under local anesthetic and /or sedation with transfemoral access in 94.7 % and transaortic in 5.3 % . Three device sizes were used : 23 mm ( n = 66 , 28.9 % ) , 25 mm ( n = 39 , 17.1 % ) , and 27 mm ( n = 123 , 53.9 % ) . The valve was successfully deployed in 99.1 % of procedures . After implantation , the mean aortic gradient was 11.4 ± 5.4 mm Hg and aortic valve area 1.6 ± 0.5 cm(2 ) . In-hospital mortality was 1.8 % ( n = 4 ) . Complications included cardiac tamponade ( 1.8 % ) , conversion to sternotomy ( 1.3 % ) , stroke ( 3.9 % ) , vascular access-related ( 7.0 % ) , and acute kidney injury ( 7.9 % ) . The incidence of moderate/severe aortic regurgitation was 0.8 % ( n = 2 ) . A total of 31.8 % of patients required new permanent pacemaker implantation . CONCLUSIONS This analysis represents the largest published series on use of the LOTUS valve . Outcomes using this valve are excellent . In-hospital mortality is very low . Complication rates are low , and the LOTUS valve improves on first-generation valves , particularly with regard to residual aortic regurgitation
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 .