既往右束支传导阻滞和 TAVI 术后新发左束支传导阻滞对永久起搏器置入具有很强的预测价值，高危患者的 PPM-I 发生率高达 21%。
系统评价
在接受 TAVI 的患者中，既往右束支传导阻滞和 TAVI 术后心电图改变是否能预测对永久起搏器置入术的需求？
Systematic periprocedural ECG monitoring is crucial during TAVI, as pre-existing right bundle branch block and post-procedural new-onset LBBB, PR prolongation, and QRS widening strongly predict the need for permanent pacemaker implantation.
Effect estimate: PPM-I rates varied from 2.9%–3.5% in low-risk/no conduction abnormality groups to 18%–21% in higher-risk groups including those with pre-existing right bundle branch block (RBBB) or treated with self-expanding valves
目的 经导管主动脉瓣置入术（TAVI）与相对较高的永久起搏器置入术（PPM-I）发生率相关。我们旨在评估有关 TAVI 前后心电图（ECG）变化的现有文献，明确 PPM-I 的预测因素，并提出标准化的 TAVI 术后 ECG 监测方案。方法 在包括 PubMed、Web of Science 和 JSTOR 在内的多个数据库中进行了系统文献检索，以确定 2001 年至 2024 年间发表的研究。结果 从最初检索到的 24,170 条记录中，有 17 项研究符合纳入标准。既往右束支传导阻滞和 ECG 间期显著延长被确定为 PPM-I 的强预测因素。TAVI 术后，新发左束支传导阻滞、PR 间期延长和 QRS 波群增宽是最常见的 ECG 改变。结论 TAVI 期间进行系统性的围手术期 ECG 监测对于早期识别预示需要进行 PPM-I 的传导异常（CA）至关重要。
Tudorancea et al. (Fri,) conducted a systematic review in Adults undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis, at variable surgical risk, with reported conduction abnormalities and need for permanent pacemaker implantation. Transcatheter aortic valve implantation (TAVI) was evaluated on Incidence of conduction abnormalities (ECG changes) and permanent pacemaker implantation (PPM-I) following TAVI (PPM-I rates varied from 2.9%–3.5% in low-risk/no conduction abnormality groups to 18%–21% in higher-risk groups including those with pre-existing right bundle branch block (RBBB) or treated with self-expanding valves). Pre-existing right bundle branch block and new-onset left bundle branch block post-TAVI were strongly predictive of permanent pacemaker implantation, with PPM-I rates up to 21% in high-risk patients.