{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T22:36:50Z","timestamp":1775083010428,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The need for pacemaker is a common complication after transcatheter aortic valve replacement (TAVR). We previously described the Emory Risk Score (ERS) to predict the need for new pacemaker implant (PPM) after TAVR. Metrics included in the score are a history of syncope, pre\u2010existing RBBB, QRS duration \u2265140\u2009ms, and prosthesis oversizing \u226516%. To prospectively validate the previously described risk score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively evaluated all patients without pre\u2010existing pacemakers, ICD, or pre\u2010existing indications for pacing undergoing TAVR with the Edwards SAPIEN 3 prosthesis at our institution from March 2019 to December 2020 (<jats:italic>n<\/jats:italic>\u2009=\u2009661). Patients were scored prospectively; however, results were blinded from clinical decision\u2010making. The primary endpoint was PPM at 30 days after TAVR. Performance of the ERS was evaluated using logistic regression, a calibration curve to prior performance, and receiver operating characteristic (ROC) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 48 patients (7.3%) had PPM after TAVR. A higher ERS predicted an increased likelihood of PPM (OR 2.61, 95% CI: 2.05\u20133.25 per point, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There was good correlation between observed and expected values on the calibration curve (slope\u2009=\u20091.04, calibration at large\u2009=\u20090.001). The area under the ROC curve was 0.81 (95% CI [0.74\u20130.88], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ERS prospectively predicted the need for PPM in a serial, real\u2010world cohort of patients undergoing TAVR with a balloon\u2010expandable prosthesis, confirming findings previously described in retrospective cohorts. Notably, the prospective performance of the score was comparable with that of the initial cohorts. The risk score could serve as a framework for preprocedural risk stratification for PPM after TAVR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16061","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T09:30:36Z","timestamp":1694597436000},"page":"2225-2232","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prospective validation of a risk score to predict pacemaker implantation after transcatheter aortic valve replacement"],"prefix":"10.1111","volume":"34","author":[{"given":"George B.","family":"Black","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine Emory University School of Medicine Atlanta Georgia 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