Pacemaker Needs Rise After TAVI Procedures in Spain

TOPLINE:

The incidence of implantation of a permanent pacemaker immediately after transcatheter aortic valve implantation (TAVI) increased significantly over a period of 6 years in Spain, and this rising trend remained independent of sex, age, comorbidities, or procedural volumes at the hospitals.

METHODOLOGY:

• Researchers in Spain conducted a retrospective observational study using data from a national hospital discharge database to analyse the incidence of pacemaker implantation immediately after TAVI.
• They analysed 20,826 episodes of TAVI performed between 2017 and 2022 in patients older than 60 years without a prior pacemaker.
• The primary outcome was the implantation of a permanent pacemaker during the same hospitalisation as the TAVI procedure.

TAKEAWAY:

• Overall, 16.8% of patients required the implantation of a pacemaker, with the yearly incidence of implantation increased from 15.2% to 18.2% from 2017 to 2022 (P for trend < .001).
• The rising trend in pacemaker implantation was independent of sex, age, or burden of comorbidities and was not significantly influenced by the annual volume of TAVI performed at the hospitals.

IN PRACTICE:

“[The study] findings are clinically relevant and should be considered when selecting patients and optimising the procedure to reduce the need for post-TAVI pacemaker implantation,” the authors wrote.

SOURCE:

This study was led by Manuel Carnero-Alcázar, MD, PhD, Hospital Clínico San Carlos, Madrid, Spain. It was published online on June 18, 2025, in Open Heart.

LIMITATIONS:

The dataset used in this study lacked information on procedural characteristics such as depth of implantation and type of valve. The retrospective and observational study design prevented the investigators from determining whether the analysed variables directly increased the pacemaker risk. Pacemaker implantation was captured only during the initial admission to the hospital.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.