Arrhythmias & electrophysiologyCohort study
Mechanisms Underlying Alterations in Cardiac Conduction After Transcatheter Aortic Valve Replacement
- Prospective cohort study
- single-centre
- consecutive patients
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
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:10.1001/jamacardio.2025.4442
Summarised from the published abstract; every number is checked against it