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.