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 .
Initial Experience of a Second-Generation Self-Expanding Transcatheter Aortic Valve: The UK & Ireland Evolut R Implanters' Registry.
OBJECTIVES The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve . BACKGROUND The Evolut R is a self-exp and ing , repositionable , and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications . METHODS Clinical , procedural , and 30-day outcome data were prospect ively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Irel and . RESULTS A total of 264 consecutive Evolut R implantations were performed across 9 centers . The mean age was 81.1 ± 7.8 years , and the mean logistic European System for Cardiac Operative Risk Evaluation score was 19.9 ± 13.7 % . Procedural indications included aortic stenosis ( 72.0 % ) , mixed aortic valve disease ( 17.4 % ) , and failing aortic valve bioprostheses ( 10.6 % ) . Conscious sedation was used in 39.8 % of patients and transfemoral access in 93.6 % . The procedural success rate was 91.3 % , and paravalvular leak immediately after implantation was mild or less in 92.3 % . Major complications were rare : cardiac tamponade in 0.4 % , conversion to sternotomy in 0.8 % , annular rupture in 0.0 % , coronary occlusion in 0.8 % , major vascular in 5.3 % , acute kidney injury in 6.1 % , new permanent pacemaker implantation in 14.7 % , and procedure-related death in 0.0 % . At 30-day follow-up , survival was 97.7 % , paravalvular leak was mild or less in 92.3 % , and the stroke rate was 3.8 % . CONCLUSIONS This registry represents the largest published real-world experience of the Evolut R valve . The procedural success rate was high and safety was excellent , comparable with previous studies of the Evolut R valve and other second-generation devices . The low rate of complications represents an improvement on first-generation devices
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 .