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Late onset complete heart block after transcatheter aortic valve replacement treated with permanent His-bundle pacing

Sati Patel1, Khaled Jamoor2, Arfaat Khan1

  • 1Division of Cardiovascular Disease, Henry Ford Health System, Detroit, Michigan.

Pacing and Clinical Electrophysiology : PACE
|September 17, 2020
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) can lead to heart block. This case shows His-bundle pacing effectively treated a rare, late-presenting heart block after TAVR, suggesting its potential utility.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Conduction disturbances are frequent after TAVR, often requiring pacemaker implantation.
  • Pacemaker placement post-TAVR is linked to poorer patient outcomes.

Observation:

  • A rare case of complete heart block presenting very late after TAVR is described.
  • The patient experienced a delayed onset of severe conduction disease post-TAVR.
  • This highlights the potential for late-developing complications following the procedure.

Findings:

  • His-bundle pacing was successfully employed to treat the late-presenting complete heart block.
  • This pacing technique restored normal conduction in a challenging post-TAVR scenario.
  • The case demonstrates the feasibility of His-bundle pacing for complex conduction issues.

Implications:

  • Further research is needed to assess the long-term efficacy of His-bundle pacing in TAVR patients.
  • The findings suggest a potential role for His-bundle pacing in managing conduction disease post-TAVR.
  • Evaluating the benefits of extended cardiac monitoring post-TAVR is warranted.

Keywords:
His-bundle pacingTAVRlate conduction diseasepacingsudden cardiac death

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