A Streamline Strategy for Indication and Length of Telemetry Monitoring After TAVR

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Electrophysiology

Background:

• The optimal duration and indication for electrocardiogram (ECG) telemetry monitoring (TM) following transcatheter aortic valve replacement (TAVR) remain undefined.
• Current practices may lead to prolonged monitoring without clear clinical benefit.

Purpose of the Study:

• To test a hypothesis that a focused strategy for monitoring conductive disorders (CD) post-TAVR can safely decrease the necessity and length of inpatient TM.
• To evaluate the safety and efficacy of a protocolized approach to post-TAVR monitoring.

Main Methods:

• Prospective evaluation of patients undergoing transfemoral TAVR.
• ICU transfer for TM was based on pre-existing or new/worsening conductive disorders (CD).
• Standardized TM duration of 24–48 hours; primary endpoint was severe CD outside ICU at 1-month follow-up.

Main Results:

• Of 250 patients, 55.2% required TM, primarily for new left bundle branch block.
• The primary endpoint of severe CD outside the ICU was met by only 1.20% of patients.
• Absence of TM correlated with significantly shorter global hospitalization (1.43 vs. 2.93 days, p<0.001).

Conclusions:

• Selective TM indication and duration after TAVR is feasible and safe, with no in-hospital events or deaths.
• Nearly half of patients avoided TM, and significantly shorter ICU and overall hospital stays were achieved.
• This strategy confirms safety and efficiency in post-TAVR cardiac monitoring.