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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353545PMC
http://dx.doi.org/10.15420/cfr.2021.05DOI Listing

Publication Analysis

Top Keywords

havb tavr
12
transcatheter aortic
8
aortic valve
8
valve replacement
8
hospitalisation tavr
8
risk factors
8
management strategies
8
tavr
6
havb
6
evaluation management
4

Similar Publications

Article Synopsis
  • * Optimize PRO, a prospective study, implements two strategies: using a cusp overlap technique during TAVR and a CD algorithm that assesses patients based on their post-procedure ECG for early discharge decisions.
  • * Results indicate that patients with conduction disturbances had a significantly higher PPI rate at 30 days compared to those without (28.1% vs 1.5%), but the standardized management of CDs led to similar safety outcomes, suggesting effective early recognition and monitoring of arrhythm
View Article and Find Full Text PDF

Background: Conduction disease is an important and common complication post-transcatheter aortic valve replacement (TAVR). Previously, we developed a conduction disease risk stratification and management protocol post-TAVR. This study aims to evaluate high-grade aortic valve block (HAVB) incidence and risk factors in a large cohort undergoing ambulatory cardiac monitoring post-TAVR according to conduction risk grouping.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the development of arrhythmias in patients at risk of high-degree atrioventricular block (HAVB) or complete heart block (CHB) after undergoing transcatheter aortic valve replacement (TAVR) using smartwatch technology.
  • It analyzes data from 188 patients monitored for 30 days post-TAVR, focusing on the incidence and timing of arrhythmic events and pacemaker implantation.
  • Results show an increased incidence of left bundle branch block (LBBB) initially, with higher pacemaker implantation rates in patients at greater risk of HAVB/CHB, and identified factors predictive of needing a pacemaker.
View Article and Find Full Text PDF

Background: The permanent pacemaker (PPM) implantation and pacemaker dependency rates after transcatheter aortic valve replacement (TAVR) are highly variable as some of the conduction disturbances are reversible. It remains poorly investigated how to optimise temporary pacing in these patients. This study aimed to explore the potential reduction in the PPM implantation rate using temporary-permanent pacemaker (TPPM) as a 1-month bridge.

View Article and Find Full Text PDF

Transcatheter aortic valve replacement (TAVR) has increasingly become a safe, feasible, and widely accepted alternative surgical treatment for patients with severe symptomatic aortic stenosis. However, the incidence of conduction abnormalities associated with TAVR, including left bundle branch block (LBBB) and high-degree atrioventricular block (HAVB), remains high and is often correlated with risk factors such as the severity of valvular calcification, preexisting conditions in patients, and procedural factors. The existing research results on the impact of post-TAVR conduction abnormalities and permanent pacemaker (PPM) requirements on prognosis, including all-cause mortality and rehospitalization, remain contradictory, with varied management strategies for post-TAVR conduction system diseases across different institutions.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!