Perioperative conduction disturbances after transcatheter aortic valve replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• Cardiac conduction disturbances are common following transcatheter aortic valve replacement (TAVR).
• Atrial fibrillation and atrioventricular block are significant concerns in TAVR patients.
• Current clinical guidelines for managing these arrhythmias post-TAVR are lacking due to limited clinical trials.

Purpose of the Study:

• To review the incidence, risk factors, and outcomes of conduction disturbances after TAVR.
• To highlight the need for clinical trials to address the evidence gap in managing arrhythmias post-TAVR.
• To emphasize the importance of minimizing cardiac conductive system damage during TAVR procedures.

Main Methods:

• Review of current evidence regarding cardiac conduction disturbances after TAVR.
• Analysis of risk factors, incidence, and outcomes of arrhythmias like atrial fibrillation and atrioventricular block.
• Discussion of the implications for patient management and future research.

Main Results:

• Heart block of all types is common after TAVR and may necessitate permanent pacemaker implantation.
• The evidence base details the incidence, risk factors, and outcomes of these conduction disturbances.
• Atrial fibrillation post-TAVR has been increasingly recognized for its risk factors and effects on outcomes.

Conclusions:

• Prompt recognition and management of atrioventricular block are crucial for patients undergoing TAVR.
• Minimizing damage to the cardiac conductive system remains a key focus as TAVR practices evolve.
• Future research and clinical trials are needed to establish guidelines for managing arrhythmias post-TAVR, especially with novel prostheses.