Do Women Require Less Permanent Pacemaker After Transcatheter Aortic Valve Implantation? A Meta-Analysis and Meta-Regression

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Abstract

Background

Limited clinical evidence and literature are available about the potential impact of sex on permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI). The aim of this work was to evaluate the relationship between sexes and atrioventricular conduction disturbances requiring PPI after TAVI.

Methods and Results

Data were obtained from 46 studies from PubMed reporting information about the impact of patient sex on PPI after TAVI. Total proportions with 95% Cls were reported. Funnel plot and Egger test were used for estimation of publication bias. The primary end point was 30-day or in-hospital PPI after TAVI, with odds ratios and 95% CIs extracted. A total of 70 313 patients were included, with a cumulative proportion of 51.5% of women (35 691 patients; 95% CI, 50.2-52.7). The proportion of women undergoing TAVI dropped significantly over time (P

Conclusions

Female sex is associated with a reduced rate of PPI after TAVI, without influence of age or ventricular function. Balloon-expandable devices attenuate this advantage in favor of women. Additional investigations are warranted to elucidate sex-based differences in developing conduction disturbances after TAVI.

Original languageEnglish
Article number019429
Number of pages25
JournalJournal of the American Heart Association
Volume10
Issue number7
DOIs
Publication statusPublished - 6 Apr 2021

Keywords

  • permanent pacemaker
  • sex
  • transcatheter aortic valve implantation
  • women
  • STENOSIS
  • LONG-TERM OUTCOMES
  • SEX-RELATED DIFFERENCES
  • REPLACEMENT
  • IMPACT
  • BUNDLE-BRANCH BLOCK
  • PREDICTORS
  • GENDER
  • CONDUCTION DISTURBANCES
  • CLINICAL-OUTCOMES

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