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A Disruptive Technology: Determining Need for Permanent Pacing After TAVR
Amneet Sandhu1,2, Wendy S Tzou3
1Division of Cardiology, Cardiac Electrophysiology Section, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA.
Current Cardiology Reports
|April 19, 2021
Summary
Transcatheter aortic valve replacement (TAVR) can cause heart rhythm problems. This review covers pacemaker needs after TAVR, risk factors, and future research for better patient outcomes.
Area of Science:
- Cardiology and Interventional Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Severe aortic stenosis management has been transformed by Transcatheter Aortic Valve Replacement (TAVR).
- Despite significant advancements in TAVR technology and techniques over 20 years, conduction system disturbances remain a notable complication.
- Left bundle branch block (LBBB) is a frequent post-TAVR conduction abnormality.
Purpose of the Study:
- To review permanent pacemaker (PP) implant rates following TAVR.
- To identify risk factors predicting the need for PP therapy post-TAVR.
- To discuss the management of perioperative conduction abnormalities and explore novel research directions.
Main Methods:
- This is a review article synthesizing current literature and data.
- Analysis of existing studies on TAVR-associated conduction disturbances.
- Examination of recent consensus statements and guideline documents.
Main Results:
- Conduction disturbances, particularly LBBB, are common after TAVR.
- While some disturbances may resolve over time, pacemaker therapy rates remain substantial.
- New research offers potential for improved prediction and management of these complications.
Conclusions:
- Standardized approaches to managing post-TAVR conduction issues are emerging.
- Ongoing research is crucial for refining prediction and treatment strategies.
- Addressing conduction disturbances is key to optimizing TAVR outcomes.
