Why the study?
Transcatheter aortic valve replacement often leads to conduction abnormalities necessitating pacemaker implantation, but there is a lack of consensus in managing these post-TAVR disturbances.
What are the risk factors for conduction abnormalities leading to permanent pacemaker implantation post-TAVR?
What are the risk factors for conduction abnormalities leading to permanent pacemaker implantation post-TAVR?
Preexisting conduction abnormalities, male sex, older age, and the use of self-expandable valves are key risk factors for permanent pacemaker implantation after TAVR, highlighting the need for tailored procedural planning.
May guide pre-TAVR conduction risk assessment; leaves open prospective validation of modifiable factors.
Transcatheter aortic valve replacement (TAVR) often leads to conduction abnormalities, necessitating pacemaker implantation. This review of 38 meta-analyses identified preexisting right bundle branch block (RBBB), LAHB, and new-onset left bundle branch block as key risk factors, with a higher PPM risk in male and older patients. Procedural factors like transfemoral access and self-expandable valves also increase this risk. Prevention focuses on tailoring TAVR to individual electrophysiological and anatomical profiles. However, there's a lack of consensus in managing these conduction disturbances post-TAVR, highlighting the need for further research and standardized treatment strategies.
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Ghazal et al. (2024) studied this question.
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