Conduction Abnormalities Linked with Pacemaker after TAVR

This study looking at electrocardiographic data that could potentially correlate with delayed progression up to heart block and need for a pacemaker, looked at 608 patients who underwent transcatheter aortic valve replacement (TAVR) between April 2008 and June 2017 (excluding 164 patients expiring within 24 hours of the procedure and another 50 who received a pacemaker within 24 hours of TAVR). The most commonly seen abnormalities, according to the study, were left bundle branch block, intraventricular conduction delay, left anterior fascicular block, and right bundle branch block.  Both left- and right-bundle branch block were associated with an increased risk for pacemaker implantation after TAVR. “Left bundle branch block, right bundle branch block, and delta-PR greater than 40 ms were all associated with delayed progression to complete heart block and need for pacemaker implantation after TAVR,” the authors wrote.

Cresse S, et al. Pacing Clin Electrophysiol. 2019;doi:10.1111/pace.13695