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

Justine M. Ravaux; Michele Di Mauro; Kevin Vernooy; Arnoud W. Van't Hof; Leo Veenstra; Suzanne Kats; Jos G. Maessen; Roberto Lorusso

doi:10.1161/JAHA.120.019429

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

Justine M. Ravaux^*, Michele Di Mauro, Kevin Vernooy, Arnoud W. Van't Hof, Leo Veenstra, Suzanne Kats, Jos G. Maessen, Roberto Lorusso

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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 language	English
Article number	019429
Number of pages	25
Journal	Journal of the American Heart Association
Volume	10
Issue number	7
DOIs	https://doi.org/10.1161/JAHA.120.019429
Publication status	Published - 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

Access to Document

10.1161/JAHA.120.019429Licence: CC BY-NC-ND

Cite this

@article{e381109612374e49ae69fd6b258d0026,

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

abstract = "BackgroundLimited 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 ResultsData 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 (PConclusionsFemale 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.",

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",

author = "Ravaux, {Justine M.} and {Di Mauro}, Michele and Kevin Vernooy and {Van't Hof}, {Arnoud W.} and Leo Veenstra and Suzanne Kats and Maessen, {Jos G.} and Roberto Lorusso",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.",

year = "2021",

month = apr,

day = "6",

doi = "10.1161/JAHA.120.019429",

language = "English",

volume = "10",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley",

number = "7",

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TY - JOUR

T1 - Do Women Require Less Permanent Pacemaker After Transcatheter Aortic Valve Implantation? A Meta-Analysis and Meta-Regression

AU - Ravaux, Justine M.

AU - Di Mauro, Michele

AU - Vernooy, Kevin

AU - Van't Hof, Arnoud W.

AU - Veenstra, Leo

AU - Kats, Suzanne

AU - Maessen, Jos G.

AU - Lorusso, Roberto

PY - 2021/4/6

Y1 - 2021/4/6

N2 - BackgroundLimited 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 ResultsData 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 (PConclusionsFemale 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.

AB - BackgroundLimited 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 ResultsData 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 (PConclusionsFemale 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.

KW - permanent pacemaker

KW - sex

KW - transcatheter aortic valve implantation

KW - women

KW - STENOSIS

KW - LONG-TERM OUTCOMES

KW - SEX-RELATED DIFFERENCES

KW - REPLACEMENT

KW - IMPACT

KW - BUNDLE-BRANCH BLOCK

KW - PREDICTORS

KW - GENDER

KW - CONDUCTION DISTURBANCES

KW - CLINICAL-OUTCOMES

U2 - 10.1161/JAHA.120.019429

DO - 10.1161/JAHA.120.019429

M3 - (Systematic) Review article

C2 - 33779244

SN - 2047-9980

VL - 10

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 7

M1 - 019429

ER -