Introduction Catheter ablation (CA) can interfere with cardiac implantable electronic device (CIED) function. The safety of CA in the 1 st year after CIED implantation/lead revision is uncertain. Methods This single center, retrospective cohort included patients who underwent CA between 2012-2017 and had a CIED implant/lead revision within the preceding year. We assessed the frequency of device/lead malfunction in this population. Results We identified 1810 CAs in patients between 2012-2017, with 170 CAs in 163 patients within a year of a CIED implant/lead revision. Mean age 68 ± 12 years (68% men). Time between the CIED procedure and CA was 158 ± 99 days. The CA procedures included AF ablation (n=54, 32%), AV node ablation (n=41, 24%), atrial flutter ablation (n=25, 15%), and PVC/VT ablations (n=24, 14%). The cumulative frequency of lead dislodgement, significant CIED dysfunction, and/or CIED-related infection following CA was (n=1/170, 0.6%). There was a single atrial lead dislodgement (0.6%). There were no instances of power-on-reset or CIED-related infection. Following CA, there was no significant difference in RA or RV lead sensing (p=0.52 and 0.84 respectively) or thresholds (p=0.94 and 0.17 respectively). The RA impedance slightly decreased post-CA from 474 ± 80 Ohms to 460 ± 73 Ohms (p=0.002), as did the RV impedance (from 515 ± 111 Ohms to 497 ± 98 Ohms, p<.0001). Conclusions CA can be performed within 1 year following CIED implantation/lead revision with a low risk of CIED/lead malfunction or lead dislodgement. The ideal time to perform CA after a CIED remains uncertain.

Background: In-hospital permanent pacemaker implantation (PPMI) is a frequent and well-known complication of transcatheter aortic valve replacement (TAVR) procedure. The period of monitoring for need for pacing after discharge remains poorly understood. Methods: The National Readmission Database from first six months of calendar year 2016 and 2017 was queried for patient discharged alive after TAVR. All patients with prior pacemakers were excluded. Patients who received pacemaker after discharge (d-PPMI) were compared to a) patients receiving no pacemaker (o-PPMI) or b) patients receiving pacemaker on index admission(i-PPMI) over a 6 month follow-up. Results: Out of 39,993 patients who did not have a prior pacemaker, 4001(10.0%) underwent PPM implantation during index admission (i-PPMI) while over the next 6 months, a further 734 (1.8%) patients underwent the procedure (d-PPMI). For patients receiving PPMI during follow-up post TAVR discharge, the majority (68%) occurred within 14 days. The primary cause of readmission for d-PPMI was heart block in majority of the cases (73%; complete heart block 49%, second degree heart block 4%, bradycardia/other heart block 20%). The d-PPMI group also had a relatively shorter length of stay and a lower comorbidity burden when compared to the i-PPMI group. When compared to the o-PPMI group, the d-PPMI group were more likely to have higher advanced heart block. Conclusions: About one-fifth of pacemakers implanted post TAVR procedures happen during follow-up with a majority of them happening immediately after discharge. Risk stratification at discharge may help to identify patients who undergo PPMI post discharge.