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Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert

Josep Rodés-Cabau1, Kenneth A Ellenbogen2, Andrew D Krahn3

  • 1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.

Journal of the American College of Cardiology
|August 24, 2019
PubMed

Insights

Conduction disturbances remain common after transcatheter aortic valve replacement (TAVR). This expert consensus provides a needed uniform strategy for managing these frequent TAVR complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Transcatheter aortic valve replacement (TAVR) has seen significant periprocedural complication improvements.
  • Conduction disturbances persist as the most frequent complication post-TAVR.
  • Lack of consensus on managing these disturbances leads to treatment uncertainty and variable pacemaker rates.

Purpose of the Study:

  • To establish a uniform strategy for managing conduction disturbances following TAVR.
  • To provide guidance based on current data and expert consensus.

Main Methods:

  • Formulation of an expert consensus document.
  • Multidisciplinary panel including interventional cardiologists, electrophysiologists, and cardiac surgeons.
  • Review of best available data and group expertise.

Main Results:

  • Identified conduction disturbances as the most frequent TAVR complication.
  • Highlighted the lack of consensus and variability in pacemaker rates post-TAVR.
  • Developed a proposed management guide.

Conclusions:

  • There is an urgent need for a standardized approach to post-TAVR conduction disturbances.
  • This consensus document offers an initial framework for management.
  • Expert collaboration is crucial for addressing this common complication.

Keywords:
aortic stenosisconduction disturbancespacemakertranscatheter aortic valve replacement

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