<h2 class="section-title u-h3 u-margin-l-top u-margin-xs-bottom">Abstract</h2> <div id="as0005"> <h3 id="st0010" class="u-h4 u-margin-m-top u-margin-xs-bottom">Background</h3> <p id="sp0020">Tissue edema and inflammation, which occur at the device landing zone during valve deployment, may contribute to the <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/pathophysiology" title="Learn more about Pathophysiology from ScienceDirect's AI-generated Topic Pages">pathophysiology</a> of conduction abnormalities after <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/percutaneous-aortic-valve-replacement" title="Learn more about Percutaneous Aortic Valve Replacement from ScienceDirect's AI-generated Topic Pages">transcatheter aortic valve replacement</a> (TAVR).</p> <p id="sp0025">We hypothesized that exposure to <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/glucocorticoid" title="Learn more about Glucocorticoid from ScienceDirect's AI-generated Topic Pages">glucocorticoids</a> prior to TAVR will reduce the incidence of conduction abnormalities requiring PPM <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/implantation" title="Learn more about Implantation from ScienceDirect's AI-generated Topic Pages">implantation</a> after TAVR.</p> </div> <div id="as0010"> <h3 id="st0015" class="u-h4 u-margin-m-top u-margin-xs-bottom">Methods</h3> <p id="sp0030">We included 167 consecutive patients treated with TAVR at the Minneapolis VA Medical Center and University of Minnesota. Exposure to glucocorticoids was assessed by linking electronic medical and pharmacy records. The primary outcome was a new PPM within 30 days of the index TAVR procedure.</p> </div> <div id="as0015"> <h3 id="st0020" class="u-h4 u-margin-m-top u-margin-xs-bottom">Results</h3> <p id="sp0035">Of the 167 patients included, 16 (9.5%) were exposed to glucocorticoids prior to TAVR. No differences in age, <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/society-of-thoracic-surgeons-score" title="Learn more about Society of Thoracic Surgeons Score from ScienceDirect's AI-generated Topic Pages">STS score</a>, pre-existing <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/right-bundle-branch-block" title="Learn more about Right Bundle Branch Block from ScienceDirect's AI-generated Topic Pages">right bundle branch block</a>, implantation depth or valve type were seen among patients exposed to glucocorticoids versus those who were unexposed. Patients exposed to glucocorticoids were more likely to have moderate/severe COPD (43% versus 18%, <em>p</em> < 0.01). The cumulative incidence of PPM implantation at 30-days after TAVR was 18%. None of the patients exposed to glucocorticoids required a PPM while 30 (19%) of the unexposed patients did (<em>p</em> = 0.04).</p> </div> <div id="as0020"> <h3 id="st0025" class="u-h4 u-margin-m-top u-margin-xs-bottom">Conclusions</h3> <p id="sp0040">Exposure to glucocorticoids prior to TAVR may be associated with reduced incidence of PPM requirement though larger studies are needed to support these findings. Tissue edema and inflammation may be significant contributors to the pathophysiology of conduction abnormalities after TAVR and could represent a therapeutic target.</p> </div>