The Electrocardiogram After Transcatheter Aortic Valve Replacement Determines the Risk for Post-Procedural High-Degree AV Block and the Need for Telemetry Monitoring

Abstract

Patients without conduction disorders post-TAVR did not develop delayed high-degree AVB. Such patients may not require telemetry monitoring. All other patients should be monitored until the ECG remains stable for at least 2 days. This algorithm should be validated in a separate patient population.

Characteristics of and current practice patterns of pacing for high‐degree atrioventricular block after transcatheter aortic valve implantation in comparison to surgical aortic valve replacement

“…The reported incidences of HDAVB after TAVI varied depending on the type of valve used in the procedure; 6.8% to 10.8% for BEV and 19.3% to 35.7% for SEV . Despite lack of specific information for the type of valve, our analysis mostly reflects data on BEV, since the national registry data in the United States up to September 2014 showed an 11.2% rate of SEV use .…”

“…Furthermore, although the rate of permanent pacemaker implantation after TAVI has been well described, the overall incidence of HDAVB after TAVI in comparison to SAVR remains incompletely described. [15][16][17] In this context, we aimed to investigate the incidence of HDAVB, and the current practice patterns of permanent pacing for HDAVB following TAVI in comparison to SAVR using a large-scale inpatient database. base is available to the public as aggregate data without direct personal identifiers.…”

“…in the TAVI group and 5.6% in the SAVR group; (2) permanent pacemakers were implanted earlier after TAVI compared to SAVR (the median interval of 2 days vs 5 days); and (3) among the patients who developed HDAVB, patients in the TAVI group were more likely to undergo permanent pacemaker implantation than those in the SAVR group (74.1% vs 64.7%). [15][16][17]20 Despite lack of specific information for the type of valve, our analysis mostly reflects data on BEV, since the national registry data in the United States up to September 2014 showed an 11.2% rate of SEV use. 14 Considering these factors, the 10.3% incidence of HDAVB after TAVI in our cohort is overall consistent with prior reports.…”

“…Comparative data regarding current practice patterns of permanent pacing for HDAVB, especially the timing of implantation, between TAVI and SAVR are limited. Furthermore, although the rate of permanent pacemaker implantation after TAVI has been well described, the overall incidence of HDAVB after TAVI in comparison to SAVR remains incompletely described . In this context, we aimed to investigate the incidence of HDAVB, and the current practice patterns of permanent pacing for HDAVB following TAVI in comparison to SAVR using a large‐scale inpatient database.…”

Transcatheter aortic valve replacement: The year in review 2016

“…Avoidance of balloon pre‐dilation before TAVR may reduce new onset persistent LBBB with Core valve . Patients who do not exhibit any conduction disorders in the peri‐procedural period are very unlikely to develop delayed high degree AV block and may not require telemetry monitoring . In a meta‐analysis of 17 studies, new‐onset LBBB post‐TAVR was associated with a higher risk of PPM and cardiac death during follow‐up, and a tendency toward higher all‐cause mortality.…”