Incidence of 180-day Readmission With CIED Implantation After Percutaneous and Surgical Aortic and Mitral Valve Interventions.

INTRODUCTION

Valvular interventions are associated with conduction disturbances requiring cardiac implantable electronic device (CIED) implantation. While prior studies have focused on early device implantation post-aortic interventions, less is known about delayed events, comparisons with surgical approaches, and outcomes following mitral interventions.

OBJECTIVES

This study aimed to compare the incidence and timing of CIED implantation within 180 days after surgical and transcatheter aortic and mitral valve interventions.

METHODS

We analyzed the Nationwide Readmissions Database (2016-2021) to identify patients undergoing transcatheter aortic valve replacement (TAVR), surgical AVR (SAVR), transcatheter mitral valve replacement/repair (TMVR/TEER), or surgical MVR (SMVR). Readmissions within 180 days for CIED implantations were identified. Weighted analyses and Cox proportional-hazards models adjusted for demographics, comorbidities, and hospital factors were used.

RESULTS

Transcatheter patients were older and had a higher comorbidity burden than surgical patients. The 180-day readmission rate for CIED implantation was higher after TAVR versus SAVR (2.33% vs. 0.88%; adjusted HR 2.05, 95% CI 1.84-2.29, p < 0.001). Readmissions with CIED implantation occurred earlier following TAVR vs SAVR (median 10 days vs. 49 days). TMVR/TEER and SMVR had similar overall rates at 180 days (1.66% vs. 1.71%; HR 0.97, 95% CI 0.80-1.19, p = 0.80). Compared to aortic valve interventions, where readmissions with CIED implantation clustered early, readmissions with CIED implantation after mitral valve interventions were more evenly distributed over the first 6 months.

CONCLUSION

Readmissions with CIED implantation within the first 6 months post-procedure occur earlier following aortic valve compared to mitral valve interventions. Whereas the incidence of readmission for CIED implantation was higher with TAVR compared to SAVR, readmission rates for CIED implantation were comparable over the first 6 months following surgical and percutaneous mitral interventions. These data have implications for the timing and duration of rhythm monitoring after discharge following valve interventions.