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 .
One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
Background Transcatheter aortic valve implantation ( TAVI ) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis . Aims PARTNER EU is the first study to evaluate prospect ively the procedural and mid-term outcomes of transfemoral ( TF ) or transapical ( TA ) implantation of the Edwards SAPIEN ® valve involving a multi-disciplinary approach . Methods and results Primary safety endpoints were 30 days and 6 months mortality . Primary efficacy endpoints were haemodynamic and functional improvement at 12 months . One hundred and thirty patients ( 61 TF , 69 TA ) , aged 82.1 ± 5.5 years were included . TA patients had higher logistic EuroSCORE ( 33.8 vs. 25.7 % , P = 0.0005 ) and more peripheral disease ( 49.3 vs. 16.4 % , P < 0.0001 ) . Procedures were aborted in four TA ( 5.8 % ) and six TF cases ( 9.8 % ) . Valve implantation was successful in the remaining patients in 95.4 and 96.4 % , respectively . Thirty days and 6 months survival were 81.2 and 58.0 % ( TA ) and 91.8 and 90.2 % ( TF ) . In both groups , mean aortic gradient decreased from 46.9 ± 18.1 to 10.9 ± 5.4 mmHg 6 months post-TAVI . In total , 78.1 and 84.8 % of patients experienced significant improvement in New York Heart Association ( NYHA ) class , whereas 73.9 and 72.7 % had improved Kansas City Cardiomyopathy Question naire ( KCCQ ) scores in TA and TF cohorts , respectively . Conclusion This first team-based multi-centre European TAVI registry shows promising results in high-risk patients treated by TF or TA  delivery . Survival rates differ significantly between TF and TA groups and probably reflect the higher risk profile of the TA cohort . Optimal patient screening , approach selection , and device refinement may improve outcomes
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 .