Cardiothoracic & vascular anesthesia
Association of Dexmedetomidine Use With Complete Heart Block After Transcatheter Aortic Valve Replacement: A Retrospective Single-Center Cohort Study
Authors' conclusion
DEX use during TAVR was not associated with increased risk of postprocedural PPM implantation.
Study context
- Population
- Transcatheter aortic valve replacement (TAVRs) performed under MAC without pre-existing permanent pacemaker (PPM), single center, January 1, 2019, to July 1, 2025
- Participants
- 2,022 TAVRs
- Exposure
- Intraoperative dexmedetomidine (DEX) at low, medium or high dose vs no DEX
- No DEXn = 786reference
- Low dosen = 354
- Medium dosen = 581
- High dosen = 301
- Outcome
- PPM implantation
Methodological detailssingle-centre, propensity-matched analysis
- Single-centre
- Propensity-matched analysis
Main finding
As reported in the abstract
Each group vs no DEXOdds ratio (95% CI)P value
Low dose
0.98(0.64–1.50)
P = 0.92Medium dose
0.78(0.50–1.22)
P = 0.28High dose
1.05(0.61–1.82)
P = 0.85Observational data: associations, not effects.
Further findings
Factors associated with PPM
| OR (95% CI) | P value | ||
|---|---|---|---|
| Male patients | 1.89 (1.36–2.64) | P < 0.001 | |
| Dialysis patients | 2.32 (1.11–4.86) | P = 0.025 | |
| Patients with high-risk preoperative electrocardiograms | 2.64 (1.75–3.99) | P < 0.001 | |
| Patients receiving self-expanding valves | 2.65 (1.77–3.96) | P < 0.001 | |
| Larger self-expanding valves | 1.25 (1.12–1.39) | P < 0.001 | |
| Post-balloon dilation | 1.51 (1.05–2.18) | P = 0.028 | |
| Aortic deploymentReduced risk | 0.96 (0.94–0.98) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | No DEX | P value |
|---|---|---|
| PPM rates, propensity-matched analysisDEX vs no-DEX · no difference · propensity-matched | 10.2% | P = 0.61 |
- PPM rates, propensity-matched analysis: DEX 9.1%
Factors associated with PPM
- Ventricular valve deployment increased PPM risk
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Association of Dexmedetomidine Use With Complete Heart Block After Transcatheter Aortic Valve Replacement: A Retrospective Single-Center Cohort Study. J Cardiothorac Vasc Anesth. Published 15 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →