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• W4377016093 abstract "Bradycardic conduction disturbance after transcatheter aortic valve replacement (TAVR) requiring permanent pacemaker (PPM) is a well-recognized complication. Leadless pacemakers (LPs) have been increasingly used in patients with indications for pacing after TAVR. Given the route of implantation and lack of a subcutaneous pocket, LPs may provide theoretical advantages in terms of efficiency and readmissions when compared to traditional transvenous single chamber pacemaker (TV-VVI). We hypothesized that patients receiving LPs in the post-TAVR setting would have a shorter length of stay (LOS) and fewer readmissions compared to those with TV-VVI implantations. To compare LOS, 30-day readmission rates, and total charges of hospitalization in patients receiving LP or TV-VVI after TAVR. The Nationwide Readmissions Database (NRD) is a nationally representative sample of all US hospitalizations, containing longitudinal patient data on almost half of all hospitalizations. The 2019 NRD was used to identify all patients who underwent TAVR and required implantation of a LP or TV-VVI from January to November 2019. Patient comorbidities and outcomes were extracted from diagnosis codes. Analysis accounted for the complex survey design of the NRD. Per NRD data reporting guidelines, any variable with n<10 was not reported. Out of 70,278 patients who underwent TAVR during the study period, 264 patients (0.4%) underwent LP implantation and 515 (0.7%) underwent TV-VVI implantation. Baseline comorbidities were similar between the two groups, except for a higher rate of atrial fibrillation (90.7% vs 70.0%, p<0.01) and tricuspid valve disease in the TV-VVI group (19.6% vs 8.2%, p<0.01). Length of stay (7.3±0.5 vs7.4 ± 0.6 days, p=0.84), time from PPM to discharge (5.6±0.6 vs 5.6±0.5, p=0.99), mortality (1.5% vs 0.8%, p=0.51), effusion/tamponade (2.1% vs 3.2%, p=0.58), and 30-day readmissions (18.8% vs 20.8%, p=0.58) were similar. There were no significant differences between hospital or payor characteristics. Total charges were significantly higher in the LP group ($290,676 ± $14,946 vs $343,320, ± $18,343, p<0.01) and remained significant on multivariate analysis (p=0.01). LP did not provide any advantage over TV-VVI in the management of post-TAVR bradyarrhythmias in terms of length of stay, 30-day readmissions, or mortality, despite similar baseline comorbidities in both groups. LP implants were also associated with a significantly higher total charges during hospitalization." @default.
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• W4377016093 date "2023-05-01" @default.
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• W4377016093 title "PO-05-044 LEADLESS VS SINGLE CHAMBER PACEMAKER IMPLANTATION IN POST-TRANSCATHETER AORTIC VALVE REPLACEMENT PATIENTS: INSIGHTS FROM THE NATIONWIDE READMISSIONS DATABASE" @default.
• W4377016093 doi "https://doi.org/10.1016/j.hrthm.2023.03.1472" @default.
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