IJCS | Volume 32, Nº5, September/October 2019

503 1. Lindroos M, Kupari M, Heikkilä J, Tilvis R. Prevalence of aortic valve abnormalities in the elderly: An echocardiographic study of a random population sample. J Am Coll Cardiol. 1993;21(5):1220-5. 2. Grinberg M, Accorsi TA. Aortic stenosis in the elderly: a Brazilian perspective. Arq Bras Cardiol. 2009;2(2):e9-12, e36-9. 3. Ross J, Braunwald E. Aortic stenosis. Circulation. 1968;38(1 Suppl):61-7 4. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J. 1987;8(5):471-83. 5. Shahian DM, O'Brien SM, Filardo G, Ferraris VA, Haan CK, Rich JB, et al; Society of Thoracic Surgeons Quality Measurement Task Force. The society of Thoracic Surgeons 2008 cardiac surgery risk models: parte 3- valve plus coronary artery bypass grafting surgery. Ann Thorac Surg. 2009;88(1 Suppl):S43-62. 6. Bouma BJ, Van den Brink RBA, Van der Meulen JHP, Verheul HA, Cheriex EC, Hamer HP, et al. To operate or not on elderly patients with aortic stenosis: the decision and its consequences. Heart. 1999;82(2):143-8. 7. Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P,et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery?. Eur Heart J. 2005;26(24):2714-20. 8. Cribier A, Eltchaninoff H, Tron C, Bauer F, Agatiello C, Nercolini D, et al. Treatment of calcific aortic stenosis with the percutaneous heart References Cedenilla et al. Requirements for permanent pacemaker afterTAVI Int J Cardiovasc Sci. 2019;32(5):492-504 Original Article is at least 2-fold higher after Sapien3 ® implantation compared to the first generation Sapien ® prosthesis. 39 The need for a permanent pacemaker using the Medtronic Evolut ® prosthesis is lower (11.7 - 25%) compared to the CoreValve ® prosthesis (9 - 38%), although with a relatively high incidence. 39 Conduction disorders requiring permanent pacemaker implantation remain a common complication after TAVI and may have a negative impact on the patients’ prognosis. 21,25,26,27,39 Strategies to reduce these complications are of great importance before extending TAVI to low-risk patients in whom these complications may have an even greater impact on prognosis. Conclusions TAVI caused the development of conduction disorders in the vast majority of patients. Seventy-seven percent of the patients developed new conduction disorders, the most frequent of which is complete AV block (32%) and left bundle branch block (30%). Approximately 30% of the patients required a permanent pacemaker implanted during hospitalization. A QRS complex with duration ≥ 120 ms, the presence of first-degree AVB, implantation of larger prostheses and the use of CoreValve were associated with the need for a permanent pacemaker in the univariate analysis. In the multivariate analysis, the only variable considered to be an independent predictor of the need for pacemaker implantation after TAVI was the presence of first-degree AVB. The survival of patients who developed new conduction disorders after TAVI was numerically worse than the survival of the rest of the population. This result was not statistically significant. The lack of statistical significance can be attributed to the relatively short analysis time and small sample size. Author contributions Conception and design of the research: Santos MC, Azevedo FS, Rodrigues LCD, Weksler C, Colafranceschi AS, Lacerda GC. Acquisition of data: Santos MC, Azevedo FS, Rodrigues LCD, Colafranceschi AS, Lacerda GC. Analysis and interpretation of the data: Santos MC, Lamas CC, Lacerda GC. Statistical analysis: Santos MC, Lacerda GC. Writing of the manuscript: Santos MC, Lacerda GC. Critical revision of the manuscript for intellectual content: Santos MC, Lamas CC, Weksler C, Colafranceschi AS, Lacerda GC. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of master submitted by Marcela Cedenilla dos Santos, from Instituto Nacional de Cardiologia . Ethics approval and consent to participate This study was approved by the Ethics Committee of the Instituto Nacional de Cardiologia under the protocol number 1.334.739. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study.