Key result
Transcatheter aortic valve replacement carries a significant risk of conduction disturbances, with new-onset left bundle branch block occurring in 19-55% of patients and high-degree atrioventricular block in approximately 10%.
Why the study?
Despite widespread adoption of TAVR, conduction disturbances like new-onset LBBB and high-grade AV block requiring permanent pacemaker implantation remain significant challenges.
Conduction disturbances remain a frequent and clinically significant complication of TAVR, necessitating careful pre-procedural risk stratification, particularly regarding membranous septal length and pre-existing right bundle branch block.
Demands vigilance for conduction issues as TAVR expands to low-risk patients; leaves open optimal prevention and pacing strategies.
Transcatheter aortic valve replacement (TAVR) offers a minimally invasive alternative to traditional surgical aortic valve replacement (SAVR) for the treatment of severe aortic stenosis. Notably, TAVR was once reserved for patients at high surgical risk but is now a viable option even for those at low surgical risk. Despite the widespread adoption and favorable outcomes of TAVR, this technique presents several challenges, including conduction disturbances such as new-onset left bundle branch block (LBBB) and high-grade atrioventricular (AV) block, which may require permanent pacemaker (PPM) implantation. These complications arise from the close anatomical relationship between the aortic valve and the cardiac conduction system and are influenced by factors such as valve design, implantation depth, and individual anatomical variations. This review aims to explore the structural and physiological intricacies of the aortic valve and conduction system. Additionally, this review explores pre-procedural risk stratification, monitoring protocols, and emerging strategies to mitigate these complications and enhance procedural safety and long-term patient outcomes.
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Namjouyan et al. (2026) conducted a review in Severe aortic stenosis. Transcatheter aortic valve replacement (TAVR) was evaluated. Transcatheter aortic valve replacement carries a significant risk of conduction disturbances, with new-onset left bundle branch block occurring in 19-55% of patients and high-degree atrioventricular block in approximately 10%.
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