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 .
Clinical Outcomes With a Repositionable Self-Expanding Transcatheter Aortic Valve Prosthesis: The International FORWARD Study.
BACKGROUND Clinical outcomes in large patient population s from real-world clinical practice with a next-generation self-exp and ing transcatheter aortic valve are lacking . OBJECTIVES This study sought to document the clinical and device performance outcomes of transcatheter aortic valve replacement ( TAVR ) with a next-generation , self-exp and ing transcatheter heart valve ( THV ) system in patients with severe symptomatic aortic stenosis ( AS ) in routine clinical practice . METHODS The FORWARD ( CoreValve Evolut R FORWARD ) study is a prospect i ve , single-arm , multinational , multicenter , observational study . An independent clinical events committee adjudicated safety endpoints based on Valve Academic Research Consortium-2 definitions . An independent echocardiographic core laboratory evaluated all echocardiograms . From January 2016 to December 2016 , TAVR with the next-generation self-exp and ing THV was attempted in 1,038 patients with symptomatic , severe AS at 53 centers on 4 continents . RESULTS Mean age was 81.8 ± 6.2 years , 64.9 % were women , the mean Society of Thoracic Surgeons Predicted Risk of Mortality was 5.5 ± 4.5 % , and 33.9 % of patients were deemed frail . The repositioning feature of the THV was applied in 25.8 % of patients . A single valve was implanted in the proper anatomic location in 98.9 % of patients . The mean aortic valve gradient was 8.5 ± 5.6 mm Hg , and moderate or severe aortic regurgitation was 1.9 % at discharge . All-cause mortality was 1.9 % , and disabling stroke occurred in 1.8 % at 30 days . The expected-to-observed early surgical mortality ratio was 0.35 . A pacemaker was implanted in 17.5 % of patients . CONCLUSIONS TAVR using the next-generation THV is clinical ly safe and effective for treating older patients with severe AS at increased operative risk . ( CoreValve Evolut R FORWARD Study [ FORWARD ] ; NCT02592369 )
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 .