Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert Panel

J Am Coll Cardiol. 2019 Aug 27;74(8):1086-1106. doi: 10.1016/j.jacc.2019.07.014.

Abstract

Despite major improvements in transcatheter aortic valve replacement (TAVR) periprocedural complications in recent years, the occurrence of conduction disturbances has not decreased over time and remains the most frequent complication of the procedure. Additionally, there has been an important lack of consensus on the management of these complications, which has indeed translated into a high degree of uncertainty regarding the most appropriate treatment of a large proportion of such patients along with major differences between centers and studies in pacemaker rates post-TAVR. There is therefore an urgent need for a uniform strategy regarding the management of conduction disturbances after TAVR. The present expert consensus scientific panel document has been formulated by a multidisciplinary group of interventional cardiologists, electrophysiologists, and cardiac surgeons as an initial attempt to provide a guide for the management of conduction disturbances after TAVR based on the best available data and group expertise.

Keywords: aortic stenosis; conduction disturbances; pacemaker; transcatheter aortic valve replacement.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / epidemiology
  • Aortic Valve Stenosis / surgery*
  • Atrioventricular Block / diagnosis
  • Atrioventricular Block / epidemiology
  • Atrioventricular Block / therapy
  • Bundle-Branch Block / diagnosis
  • Bundle-Branch Block / epidemiology
  • Bundle-Branch Block / surgery
  • Cardiac Conduction System Disease / diagnosis
  • Cardiac Conduction System Disease / epidemiology
  • Cardiac Conduction System Disease / therapy*
  • Cardiology / standards*
  • Consensus*
  • Disease Management
  • Expert Testimony / methods
  • Expert Testimony / standards*
  • Humans
  • Transcatheter Aortic Valve Replacement / adverse effects
  • Transcatheter Aortic Valve Replacement / standards*
  • Treatment Outcome
  • United States / epidemiology