Key result
High-degree conduction disorders remain the primary TAVR complication despite modest declines over time.
Why the study?
High degree conduction disorders requiring permanent pacemaker implantation remain the main complications of TAVR, and management strategies remain controversial with a lack of clear recommendations.
How can the risk of high-degree conduction disorders requiring permanent pacemaker implantation after TAVR be anticipated, detected, and managed?
How can the risk of high-degree conduction disorders requiring permanent pacemaker implantation after TAVR be anticipated, detected, and managed?
Conduction disorders remain a major complication of TAVR, and this review summarizes strategies for risk prediction, detection, and management, including the use of ECG, MSCT, and emerging technologies.
Answers are grounded in this paper and cite their sources.
High-degree conduction disorders post-TAVR still require vigilant evaluation; leaves open optimal management strategies.
High degree conductive disorders (CD) requiring permanent pacemaker implantation (PPI) have modestly decreased over time and remain the main complications of TAVR. Furthermore, management strategies for CD occurring after TAVR remain controversial. We proposed a review evaluating mechanisms and risk of CD after TAVR, focusing on the role of ECG evaluation but also on the importance of anatomic parameters analyzed in multi-slice computed tomography (MSCT), as well as regarding procedural aspects. Considering the lack of clear recommendations for the evaluation of risk of CD and indications of PPI, this review tries to summarize strategies to anticipate and detect the risk of high degree CD, to decrease incidence of CD and to optimize PPI indications. Perspectives regarding ambulatory monitoring, use of machine learning and new pacing techniques are proposed. This review was narrative and included selection of literature using key words including: conductive disorders, TAVR and pacemaker implantation.
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Fournier et al. (2026) conducted a review in Conduction disorders after TAVR. Transcatheter Aortic Valve Replacement (TAVR) was evaluated. This narrative review evaluates mechanisms, risk factors, and management strategies for high-degree conduction disorders requiring permanent pacemaker implantation after TAVR.
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