Arrhythmias & electrophysiology
Mechanisms Underlying Alterations in Cardiac Conduction After Transcatheter Aortic Valve Replacement
Authors' conclusion
In this cohort study, the characteristics and mechanisms causing AV block during TAVR differed from delayed block.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR) without preexisting pacemakers, single academic centre in Boston, May 2021–January 2024
- Participants
- 409 consecutive patients
- Outcome
- Mobitz type II or complete heart block
- Follow-up
- 1-year follow-up
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Heart block requiring permanent pacemaker
- Heart block requiring permanent pacemaker
- 40 (9.7%)
- Block during TAVR (all persistent)
- 15
- Atrioventricular (AV) nodal block during TAVR (all resolved)
- 6
- AV nodal delayed block
- 3 (7.5%)
- Infranodal block, intraprocedural
- 9
- Infranodal block, postprocedural
- 22
Observational data: associations, not effects.
Further findings
Predictors of heart block
- Preexisting right bundle-branch block (RBBB) the only electrocardiogram (ECG) or electrophysiological predictor of intraprocedural block; did not predict postprocedural block
- Best predictors of delayed block: His-ventricular interval ≥80 ms at end of implant, PR interval >300 ms, AV Wenckebach cycle length ≥500 ms post-TAVR
Original publication
Mechanisms Underlying Alterations in Cardiac Conduction After Transcatheter Aortic Valve Replacement. JAMA Cardiol. Published 1 January 2026. doi:10.
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