Systematic Ambulatory ECG Monitoring for Preventing Life-Threatening Cardiovascular Events Following TAVR.

BACKGROUND: Although ambulatory ECG (AECG) monitoring has been assessed after transcatheter aortic valve replacement (TAVR), its impact on life-threatening cardiovascular events remains unclear. This study aimed to evaluate whether systematic AECG monitoring after TAVR reduces life-threatening cardiovascular events during the first year of follow-up. METHODS: The study included 1217 consecutive patients who underwent TAVR and were discharged without a permanent pacemaker. Of these, 211 consecutive patients received systematic 14-day AECG monitoring at discharge as part of the RECORD registry. The remaining 1006 patients who underwent TAVR within the 3 years before and after the registry period without systematic AECG monitoring constituted the control group. The primary end point was a composite of sudden cardiac death, syncope/presyncope due to symptomatic arrhythmias, or stroke at 1-year. CONCLUSIONS: Systematic AECG monitoring after TAVR enables earlier detection of severe arrhythmias and is associated with fewer life-threatening cardiovascular events within 1 year. These findings support the need for a randomized trial. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04298593.