Pacemaker risk calculator in patients candidates for transcatheter aortic valve implantation

The development of cardiac conduction disorders (CCD) after transcatheter aortic valve implantation (TAVI) increases the incidence of pacemaker (PM) implantation. The objective of our study is to develop a risk calculator to estimate the probability of PM implantation in patients prior to the TAVI procedure, so our calculator will include only pre-TAVI predictors.

A single-center, ambispective cohort study including patients undergoing TAVI at our center between January 2021 and December 2023. Clinical-demographic data and pre-TAVI imaging parameters will be collected. Patients with a previous PM before TAVI will be excluded. The analysis will include descriptive statistics and logistic regression models.

We included 130 patients, of which 24 required PM implantation post-TAVI (18.5%). Baseline characteristics of the sample are summarized in the table [Table 1]. QRS width and the ratio between the left ventricular outflow tract diameter and the prosthesis diameter were identified as independent predictors for PM implantation after TAVI (p = 0.004 and p = 0.035, respectively). Our calculator [Figure 1] has a sensitivity of 68.4% and a specificity of 73.6%.

Our calculator establishes a predictive model that estimates the risk of PM implantation after TAVI. This provides a useful, accessible, and quick tool in clinical cardiology to predict one of the main complications for our patients.