Valvular & structural heart diseaseCohort study
Systematic Ambulatory ECG Monitoring for Preventing Life-Threatening Cardiovascular Events Following Transcatheter Aortic Valve Replacement (TAVR)
- registry
- consecutive patients
- historical control group (TAVR within the 3 years before and after the registry period)
Authors' conclusion
Systematic AECG monitoring after TAVR enabled earlier detection of severe arrhythmias and was associated with fewer life-threatening cardiovascular events within 1 year. These findings support the need for a randomized trial.
Study context
- Population
- Patients who underwent TAVR and were discharged without a permanent pacemakersystematic ambulatory ECG (AECG) monitoring (RECORD registry) 211 · control group 1,006
- Participants
- 1,217 consecutive patients
- Exposure
- Systematic AECG monitoring after TAVR vs no systematic AECG monitoring
- systematic AECGn = 211
- control groupn = 1,006reference
- Outcome
- Composite of:
- Sudden cardiac death
- Syncope/presyncope due to symptomatic arrhythmias
- Stroke
- Follow-up
- 1-year
Main finding
As reported in the abstract
Adjusted hazard ratio
0.27
CI 0.10–0.74
P = 0.011
By group
systematic AECG vs control group
adjusted hazard ratio 0.27 (CI 0.10–0.74); P = 0.011
Observational data: associations, not effects.
Further findings
| Outcome | systematic AECG | control group | adjusted hazard ratio (CI) | P value | |
|---|---|---|---|---|---|
| Sudden death or arrhythmic syncope/presyncope | 0.9% | 4.0% | 0.22 (0.05–0.89) | P = 0.034 | |
| New-onset atrial fibrillation | 8.9% | 1.8% | 5.31 (2.47–11.38) | P < 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Time to permanent pacemaker implantation · earlier in the AECG group
P < 0.001
- New-onset atrial fibrillation — New oral anticoagulation, of cases with new-onset atrial fibrillation
- 71.4%
Sudden death
- All sudden death cases occurred in the control group; median days after TAVR
- 96 (33-235)
Stroke and permanent pacemaker implantation · 1 year
- Rates similar between groups
Baseline and procedural characteristics
- Similar between groups, except higher use of self-expandable valves in the control group
- P = 0.005
Original publication
Systematic Ambulatory ECG Monitoring for Preventing Life-Threatening Cardiovascular Events Following TAVR. Circ Cardiovasc Interv. Published 30 April 2026. doi:10.1161/circinterventions.125.016288
Summarised from the published abstract; every number is checked against it