Author + information
- Received May 3, 2019
- Revision received July 5, 2019
- Accepted July 7, 2019
- Published online August 19, 2019.
- Josep Rodés-Cabau, MDa,∗ (, )
- Kenneth A. Ellenbogen, MDb,
- Andrew D. Krahn, MDc,
- Azeem Latib, MDd,
- Michael Mack, MDe,
- Suneet Mittal, MDf,
- Guillem Muntané-Carol, MDa,
- Tamim M. Nazif, MDg,
- Lars Sondergaard, MDh,
- Marina Urena, MDi,
- Stephan Windecker, MDj and
- François Philippon, MDa,∗ ()
- aQuebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
- bVirginia Commonwealth University School of Medicine, Richmond, Virginia
- cUniversity of British Columbia, Vancouver, British Columbia, Canada
- dMontefiore Medical Center, New York, New York
- eBaylor Scott & White Health, Dallas, Texas
- fValley Health System, Ridgewood, New Jersey
- gColumbia University Medical Center, New-York Presbyterian Hospital, New York, New York
- hRigshospitalet, University of Copenhagen, Copenhagen, Denmark
- iAssistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
- jBern University Hospital, University of Bern, Bern, Switzerland
- ↵∗Address for correspondence:
Dr. Josep Rodés-Cabau OR Dr. François Philippon, Catheterization and Electrophysiology Laboratories, Department of Cardiology, Quebec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada.
• A lack of consensus and large variability in the management of conduction disturbances post-TAVR exists.
• This paper provides an algorithm strategy proposal for managing conduction disturbances post-TAVR.
• Future studies need to validate the proposed algorithm and determine the role of EP studies, ambulatory continuous ECG monitoring, and prophylactic pacemaker in the management of conduction disturbance in post-TAVR patients.
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.
Dr. Rodés-Cabau has received institutional research grants from Edwards Lifesciences, Boston Scientific, and Medtronic, and holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions. Dr. Ellenbogen is a consultant for Medtronic, Boston Scientific, and Abbott; has received lecture honoraria from Medtronic, Boston Scientific, Biotronik, and Abbott; and has received research grants from Medtronic and Boston Scientific. Dr. Krahn is a consultant for Medtronic; and has received research grants from Boston Scientific and Medtronic. Dr. Latib has served on the Advisory Board for Medtronic; and has received honoraria from Abbott Vascular. Dr. Mittal is consultant for Boston Scientific and Medtronic. Dr Nazif is a consultant for and has received institutional grants from Edwards LifeSciences, Medtronic, Boston Scientific, and BioTrace Medical. Dr. Philippon is a consultant for Medtronic. Dr. Muntané-Carol is supported by a research grant from the Fundación Alfonso Martín Escudero (Madrid, Spain). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Rishi Puri, MBBS, PhD, served as Guest Associate Editor for this paper.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received May 3, 2019.
- Revision received July 5, 2019.
- Accepted July 7, 2019.
- 2019 American College of Cardiology Foundation
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