Étudiante-chercheuse étoile September 2014

Marina Ulrena Alcazar

PhD student in Experimental Medicine
Université Laval

Award-winning publicationPacemaker Implantation Following Transcatheter Aortic Valve Implantation: Impact on Late Clinical Outcomes and Left Ventricular Function

Published inCirculation,  2013-12


"The need to insert a permanent pacemaker is a common complication of transcatheter aortic valve implantation (TAVI). Our article demonstrated that the insertion of a permanent pacemaker following TAVI is not associated with increased overall or cardiovascular mortality or rehospitalisation for heart failure. In fact, a pacemaker constitutes a protective factor against unexpected death but has been linked to negative impacts on left ventricular function."

Aortic valve stenosis—the most common form of valvular heart disease—is associated with high mortality when the valve is not replaced. Currently, TAVI is a standard procedure in inoperable patients and constitutes an alternative to conventional surgery in high-risk individuals. While a pacemaker and left bundle branch block (LBBB) are the most common complications (approximately 50% of patients), their impacts remain contentious. Marina Urena Alcazar's work confirms that patients who develop LBBB without receiving a pacemaker are at a higher risk of sudden death and should be closely monitored. The research also raises questions regarding the most effective pacemaker device and the eventual need to set out a different treatment plan for patients.