{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:05:20Z","timestamp":1794258320667,"version":"4.9.0"},"reference-count":28,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:00:00Z","timestamp":1689984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Conduction disturbance requiring a new permanent pacemaker (PPM) after transcatheter aortic valve implantation (TAVI) has traditionally been a common complication. New implantation techniques with self-expanding platforms have reportedly reduced the incidence of PPM. We sought to investigate the predictors of PPM at 30 days after TAVI using Evolut R\/PRO\/PRO+; (2) Methods: Consecutive patients who underwent TAVI with the Evolut platform between October 2019 and August 2022 at University Hospital Galway, Ireland, were included. Patients who had a prior PPM (n = 10), valve-in-valve procedures (n = 8) or received &gt;1 valve during the index procedure (n = 3) were excluded. Baseline clinical, electrocardiographic (ECG), echocardiographic and multislice computed tomography (MSCT) parameters were analyzed. Pre-TAVI MSCT analysis included membranous septum (MS) length, a semi-quantitative calcification analysis of the aortic valve leaflets, left ventricular outflow tract, and mitral annulus. Furthermore, the implantation depth (ID) was measured from the final aortography. Multivariate binary logistic analysis and receiver operating characteristic (ROC) curve analysis were used to identify independent predictors and the optimal MS and ID cutoff values to predict new PPM requirements, respectively; (3) Results: A total of 129 TAVI patients were included (age = 81.3 \u00b1 5.3 years; 36% female; median EuroSCORE II 3.2 [2.0, 5.4]). Fifteen patients (11.6%) required PPM after 30 days. The patients requiring new PPM at 30 days were more likely to have a lower European System for Cardiac Operative Risk Evaluation II, increased prevalence of right bundle branch block (RBBB) at baseline ECG, have a higher mitral annular calcification severity and have a shorter MS on preprocedural MSCT analysis, and have a ID, as shown on the final aortogram. From the multivariate analysis, pre-TAVI RBBB, MS length, and ID were shown to be predictors of new PPM. An MS length of &lt;2.85 mm (AUC = 0.85, 95%CI: (0.77, 0.93)) and ID of &gt;3.99 mm (area under the curve (AUC) = 0.79, (95% confidence interval (CI): (0.68, 0.90)) were found to be the optimal cut-offs for predicting new PPM requirements; (4) Conclusions: Membranous septum length and implantation depth were found to be independent predictors of new PPM post-TAVI with the Evolut platform. Patient-specific implantation depth could be used to mitigate the requirement for new PPM.<\/jats:p>","DOI":"10.3390\/jcm12144835","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T01:15:45Z","timestamp":1690161345000},"page":"4835","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of Conduction Disturbances Requiring New Permanent Pacemaker Implantation following Transcatheter Aortic Valve Implantation Using the Evolut Series"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1040-0019","authenticated-orcid":false,"given":"Mahmoud","family":"Abdelshafy","sequence":"first","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"},{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"},{"name":"Department of Cardiology, Al-Azhar University, Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Elkoumy","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"},{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"},{"name":"Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo 11651, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham","family":"Elzomor","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"},{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"},{"name":"Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo 11651, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-8749","authenticated-orcid":false,"given":"Mohammad","family":"Abdelghani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Al-Azhar University, Cairo 11311, Egypt"},{"name":"Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3156-9510","authenticated-orcid":false,"given":"Ruth","family":"Campbell","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciara","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Kenny Gibson","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2755-2094","authenticated-orcid":false,"given":"Simone","family":"Fezzi","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Nolan","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-8989","authenticated-orcid":false,"given":"Max","family":"Wagener","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahram","family":"Arsang-Jang","sequence":"additional","affiliation":[{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"},{"name":"Discipline of Medicine, Clinical Science Institute, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh K.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Al-Azhar University, Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam","family":"Shawky","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Al-Azhar University, Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briain","family":"MacNeill","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"McInerney","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Mylotte","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"},{"name":"Discipline of Medicine, Clinical Science Institute, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0758-3539","authenticated-orcid":false,"given":"Osama","family":"Soliman","sequence":"additional","affiliation":[{"name":"Discipline of Cardiology, Galway University Hospital, SAOLTA Healthcare Group, Health Service Executive, H91 YR71 Galway, Ireland"},{"name":"CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland"},{"name":"C\u00daRAM Centre for Medical Devices, H91 TK33 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients","volume":"380","author":"Popma","year":"2019","journal-title":"N. 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Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4835\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:17:04Z","timestamp":1760127424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,22]]},"references-count":28,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12144835"],"URL":"https:\/\/doi.org\/10.3390\/jcm12144835","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,22]]}}}