Study Selection and Data Abstraction
PubMed and Embase were searched from the inception through May 2020. The keywords of transcatheter aortic valve replacement OR transcatheter aortic valve implantation OR permanent pacemaker OR atrioventricular conduction OR cardiac conduction disturbance were used to identify relevant studies. References from the retrieved articles were examined for further identification of potentially relevant studies. The search methodology was not limited to a specific population or clinical presentation. After deduplication, the study titles and abstracts were screened for relevance. Full manuscripts of potentially relevant studies were then reviewed by two independent authors (SM and RG). Any discrepancies were resolved through consensus and arbitration by a third investigator (AM). Studies were considered for inclusion if they consisted of patients who underwent PPMI for any indication within 30 days after TAVR. We included studies that listed quantitative raw data which enabled the calculation of odds ratios (OR) as predictors. Only studies that listed multivariate analysis of the predictors of interest were included; those with only univariate analysis were excluded. All studies with retrospective design, abstracts, case reports, conference presentations, editorials, reviews, and expert opinions were also excluded.
Various study and patient-related factors were extracted: number of participants; number of PPMI after TAVR; age; sex (male); number of patients with hypertension, diabetes mellitus, renal dysfunction or coronary artery disease; baseline procedural risk assessment by logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) or STS-PROM (Society of Thoracic Surgeons Predicted Risk of Mortality) score; number of patients with atrial fibrillation (AF), right bundle branch block (RBBB) or left bundle branch block (LBBB). We extracted the type of valve used – BEV [Edward Sapien (ESV), Sapien XT (XT) and Sapien 3 (S3)] versus SEV [Medtronic CoreValve Revalving System (MCRS) and Evolut R]. The data on valve size and various access sites used for TAVR (transfemoral, transapical, transaortic, trans-subclavian or trans-axillary) was also collected. Throughout the process we followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for all stages of the design and implementation (supplement table 1). Research did not include human subjects and no Institutional Review Board approval was required.