Related Experiment Video

Updated: Oct 11, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

233

Utilizing ambulatory electrocardiogram monitoring to reduce conduction related death after transcatheter aortic valve

Alexis K Okoh1,2, Chunguang Chen1, John Kassotis2,3

  • 1Department of Surgery, Division of Cardiac Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 1, 2021
PubMed

Insights

Ambulatory cardiac monitoring (ACM) effectively detects delayed advanced conduction abnormalities (DACA) after TAVR, with no 30-day mortality observed in monitored patients. Patients with normal baseline ECGs showed no DACA events, indicating a low-risk profile.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Interventional Cardiology

Background:

  • Delayed advanced conduction abnormalities (DACA) are known complications following transcatheter aortic valve replacement (TAVR).
  • These DACA can be associated with increased 30-day post-discharge mortality.
  • Early detection and management are crucial for improving patient outcomes after TAVR.

Purpose of the Study:

  • To evaluate the effectiveness of ambulatory cardiac monitoring (ACM) in identifying DACA post-TAVR.
  • To assess the association between DACA and 30-day mortality in TAVR patients.
  • To stratify DACA risk based on pre- and post-procedure electrocardiogram (ECG) findings.

Main Methods:

  • A prospective study involving 248 TAVR patients discharged without a permanent pacemaker (PPM) between October 2019 and October 2020.
  • Patients underwent 14-day ambulatory cardiac monitoring (ACM).
  • Risk stratification into three groups based on baseline, periprocedural, and discharge ECGs.

Main Results:

  • The overall incidence of DACA was 7%, with 4% requiring a PPM.
  • No mortality was observed within 30 days post-discharge.
  • DACA incidence requiring PPM was significantly higher in patients with abnormal ECGs (Group II: 4%, Group III: 8.5%) compared to those with normal ECGs (Group I: 0%, p < 0.004).

Conclusions:

  • Ambulatory cardiac monitoring (ACM) is a valuable tool for detecting DACA in TAVR patients.
  • TAVR patients with normal baseline, perioperative, and discharge ECGs exhibit a very low risk of DACA.
  • The study found no 30-day mortality in TAVR patients managed with ACM post-discharge.
Abstract

Keywords:
aortic valve diseasepercutaneous interventiontranscatheter valve implantation

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