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 .
Contemporary transcatheter aortic valve replacement with third‐generation balloon‐expandable versus self‐expanding devices
OBJECTIVES To evaluate balloon-exp and able and self-exp and ing third-generation transcatheter aortic valve replacement ( TAVR ) devices according to patient selection criteria and outcomes . BACKGROUND Two competing third-generation TAVR technologies are currently commercially available in the US . There are no published head-to-head comparisons of the relative performance of these two devices . METHODS 257 consecutive patients undergoing TAVR with a third-generation balloon-exp and able ( Edwards Sapien 3 ) or self-exp and ing device ( Medtronic CoreValve Evolut R ) at a single US medical center were included . Choice of TAVR device was at the discretion of the multidisciplinary Heart Team . Baseline clinical characteristics , echocardiographic and CT imaging , procedural and 30-day outcomes were prospect ively collected . RESULTS 74 patients received a self-exp and ing valve ( SEV ) and 183 received a balloon-exp and able valve ( BEV ) . Patients selected for SEV  were more frequently women , with lower body surface area and smaller calcified iliofemoral arteries . Three SEV patients required implantation of a second valve to successfully treat paravalvular leak . Only one BEV patient had moderate paravalvular regurgitation . There was no difference in the rate of stroke , major vascular complication or bleeding . Permanent pacemaker implantation rate was significantly higher with SEV ( 12.7 % vs 4.7 % , P = 0.49 ) and hospital length of stay was longer ( 8.3 % vs 6.5 % , P = 0.043 ) , but 30-day mortality was comparable ( 1.4 % vs 1.6 % , P = 1.00 ) . CONCLUSIONS Short-term outcomes were equivalent between the two technologies . Clinical ly significant paravalvular regurgitation was rare . SEV were more frequently selected in women and patients with challenging transfemoral access , but were associated with higher permanent pacemaker implantation rate and longer hospital length of stay
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 .