Why the study?
Conduction abnormalities and permanent pacemaker implantations remain common after TAVI, requiring Heart Teams to consider predisposing factors particularly as indications expand to younger patients with longer life expectancy.
Conduction abnormalities and the need for permanent pacemakers remain significant considerations post-TAVI, requiring careful pre-procedural screening by Heart Teams, especially as indications expand to younger, lower-risk patients.
New conduction abnormalities remain common post-TAVI; reinforces focus on RBBB as predictor and device optimization in ongoing research.
Transcatheter aortic valve implantation (TAVI) is an established alternative to surgery in patients with symptomatic severe aortic stenosis and has expanded its indications to even low-surgical-risk patients. Conduction abnormalities (CA) and permanent pacemaker (PPM) implantations remain a relatively common finding post TAVI due to the close proximity of the conduction system to the aortic root. New onset left bundle branch block (LBBB) and high-grade atrioventricular block are the most commonly reported CA post TAVI. The overall rate of PPM implantation post TAVI varies and is related to pre- and intra-procedural factors. Therefore, when screening patients for TAVI, Heart Teams should take under consideration the various anatomical, pathophysiological and procedural conditions that predispose to CA and PPM requirement after the procedure. This is particularly important as TAVI is being offered to younger patients with longer life-expectancy. Herein, we highlight the incidence, predictors, impact and management of CA in patients undergoing TAVI.
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Halapas et al. (2023) studied this question.
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