Introduction
Over the past decade, Transcatheter Aortic Valve Replacement (TAVR) has
evolved as the standard of care for patients with severe aortic stenosis
(AS). With the expansion of its use to patients with low surgical risk
the volume of TAVR procedures has increased, as has the rate of
associated complications (1). Conduction abnormalities leading to
permanent pacemaker implantation (PPMI) is one of the most common (2).
These abnormalities are believed to occur due to ischemia, hemorrhage,
edema, or trauma either during or after the procedure (3). Even with the
advances in both technology and procedural technique, and with the use
of newer generation valves, the rate of PPMI following TAVR remains
high. However, the rate differs between the two most widely used
bioprosthetic valves; the balloon-expandable valve (BEV) and the
self-expandable valve (SEV) (4). The clinical impact of PPMI is of
significant concern. This is not only due to its high incidence but also
to the potentially adverse effects on outcomes and the side effects of
long-term right ventricular pacing (5). The aim of our meta-analysis was
to systematically review and evaluate the predictors associated with
increased risk.