Impact of Conduction Abnormalities on Post-TAVI Pacemaker Implantation and Mortality Presented at London Valves

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Elizabeth Horn

Conduction disturbances are common following transcatheter aortic valve implantation (TAVI) and often lead to permanent pacemaker implantation.

In left bundle branch block, electrical impulses in the left ventricle are delayed, causing it to contract after the right. Patients may experience dizziness, heart palpitations, and fatigue. The condition may also be asymptomatic.

A team reviewed data collected on 19,203 patients who underwent TAVI in MISHC-participating hospitals between 2016 and 2024. The aim was to understand the association of baseline conduction abnormalities and new onset left bundle branch block with:

  • pre-discharge and discharge to 30-day pacemaker implantation
  • discharge to 30-day all-cause mortality

The study excluded patients with a pre-existing pacemaker. The remaining patients were categorized based on their electrocardiographic findings.

During London Valves - held November 16 - 18 in London, England - Drs. Reza Dabir and P. Michael Grossman shared that implantation of a pacemaker after TAVI was strongly associated with:

  • conduction defect before TAVI
  • new Left Bundle Branch Block after TAVI

There was also a trend toward increased early post-discharge death among patients with any conduction disturbance.

The study emphasizes that early rhythm surveillance and individualized post-TAVI pacing are required for patients with conduction system disease.

Co-authors are Mohammad Qureshi, MD; Alphonse DeLucia, MD; Ivan Hanson, MD; Rita Coram, MD; Stephane Leung, MD, MSc; Nicklaus Slocum, MD; Shukri David, MD; Pedro Villablanca, MD; Raed Alnajjar, MD; Himanshu Patel, MD; and Stanley Chetcuti, MD.