Why the study?
Despite advances leading to earlier hospital discharge after TAVR, high-degree atrioventricular block persists and is increasingly diagnosed post-discharge, warranting a review of risk factors and management strategies.
This review summarizes risk factors, timing, and management strategies for high-degree atrioventricular block following TAVR, particularly in the context of early hospital discharge.
Transcatheter aortic valve replacement (TAVR) has developed substantially since its inception. Improvements in valve design, valve deployment technologies, preprocedural imaging and increased operator experience have led to a gradual decline in length of hospitalisation after TAVR. Despite these advances, the need for permanent pacemaker implantation for post-TAVR high-degree atrioventricular block (HAVB) has persisted and has well-established risk factors which can be used to identify patients who are at high risk and advise them accordingly. While most HAVB occurs within 48 hours of the procedure, there is a growing number of patients developing HAVB after initial hospitalisation for TAVR due to the trend for early discharge from hospital. Several observation and management strategies have been proposed. This article reviews major known risk factors for HAVB after TAVR, discusses trends in the timing of HAVB after TAVR and reviews some management strategies for observing transient HAVB after TAVR.
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Mazzella et al. (2021) studied this question.
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