Intraventricular Conduction Disturbances After Transcatheter Aortic Valve Implantation

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter aortic valve implantation (TAVI) has improved outcomes for aortic stenosis.
• Periprocedural conduction disturbances, including new-onset left bundle branch block (LBBB) and new pacemaker implantation (PMI), are frequent complications.
• The proximity of the aortic valve prosthesis to the heart's conduction system is a key factor.

Purpose of the Study:

• To highlight the ongoing challenges of conduction disturbances after TAVI.
• To emphasize the need for improved strategies to prevent and manage LBBB and PMI.
• To address the implications of expanding TAVI to lower-risk populations.

Main Methods:

• Review of current literature on TAVI-related conduction disturbances.
• Analysis of factors contributing to LBBB and PMI.
• Discussion of existing evidence on the consequences of LBBB and PMI.

Main Results:

• LBBB and PMI remain significant concerns despite TAVI advancements.
• Evidence suggests potentially deleterious effects of LBBB and PMI.
• Several predisposing factors for these conduction disturbances have been identified.

Conclusions:

• Further research and innovative strategies are essential to mitigate conduction disturbances post-TAVI.
• Improved management is crucial, particularly for the growing low-risk TAVI population.
• Addressing these complications will enhance TAVI's overall safety and efficacy.