Ambulatory Electrocardiogram Monitoring in Patients Undergoing Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) has changed the treatment of patients with severe aortic stenosis. However, the occurrence of conduction disturbances has not decreased significantly over time and remains the main drawback of the procedure. In addition, new-onset atrial fibrillation is the most frequent tachyarrhythmia during the hospitalization period and is associated with worse clinical outcomes. However, little is known regarding the incidence and clinical impact of arrhythmic events beyond the periprocedural TAVR period. Ambulatory electrocardiogram (AECG) monitoring has recently emerged as a tool to unravel the complex issue of arrhythmic disorders (bradyarrhythmias and tachyarrhythmias) before and after TAVR. To date, the preliminary results from the initial experience using AECG monitoring systems showed the safety, usefulness, and potential clinical implications of this diagnostic tool in TAVR recipients. This review provides an overview of the current status, clinical implications, and future perspectives of AECG monitoring in the TAVR setting. (J Am Coll Cardiol 2021;77:1344?56) ? 2021 by the American College of Cardiology Foundation.

Automated summary

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis, but the occurrence of conduction disturbances and new-onset atrial fibrillation post-procedure remains a challenge. Ambulatory electrocardiogram (AECG) monitoring has emerged as a valuable tool for diagnosing arrhythmic events before and after TAVR, showing promising safety and clinical implications.