Abstract 89: Temporary Pacing And Clinical Outcomes In The Tavr Patient

Introduction: Transvenous pacemaker (TVP) use during transcatheter aortic valve replacement (TAVR) is routinely utilized to rapid pace the ventricle to assist in valve deployment and treat conduction abnormalities. This study aimed to evaluate the outcomes of patients who had their TVP left in place post procedure as compared to those patients where the TVP was removed in the operating room.

Methods: A retrospective analysis of medical records for TAVR patients from 2018-2020 at the University of Illinois Hospital was conducted. These patients were placed into two groups: Those with TVP left in place and those without TVP. Patients with a pacemaker prior to procedure were excluded (11). Primary outcomes included composite MACE (all-cause mortality, MI, or CVA) at 6 months and 12 months. Secondary aims included length of stay (LOS) and ICU length of stay (ILOS).

Results: A total of 138 patients were included for analysis. Of this population, 78% (109) were male, 54% (71) non-white, and mean age of 75+/- 12 years old. TVP was left in post procedure for 41 patients (29%). When comparing patients with TVP in place post procedure and those without, there was no difference in 6-month composite MACE (4.9% vs 13.4%, p=0.14). This was redemonstrated at 12 months (9.8% vs 22.6% p=0.076). There was no significant difference in LOS (2.88 vs 2.82 p=0.92). ILOS was significantly longer for those with TVP in place vs. those without (0.63 vs 0.08 days, p=0.006).

Conclusion: Our results indicate that a TVP left in place is not significantly associated with composite MACE. Though presence of a TVP is associated with longer ICU stay it is not associated with longer total LOS. We noted that those with TVP in place post procedure did have lower percentage of composite MACE however the reasons for this trend are unclear. The prognostic implication of TVP left in place post TAVR remains to be determined. Further evaluation into the relationship of TVP and clinical outcomes should be investigated to better understand the clinical significance of this practice.