The Conjunction Conundrum in Transcatheter Aortic Valve Implantation

A continuous discussion regarding the predic-tors for permanent pacemaker implantation (PPI) fol-lowing transcatheter aortic valve implantation (TAVI) is ongoing, especially in the era of low and medium risk patients. The aim of this article is to review the data so far regarding the pathophysiology, risk factors, and the indications for permanent pacemaker implantation after TAVI. The factors that contribute to rhythm abnormali-ties post TAVI can be divided into pre-existing conduc-tion abnormalities, patient-related anatomical factors, and peri-procedural technical factors. The latter compo-nents are potentially modifiable, and this is where atten-tion should be directed, particularly now that in an era of TAVI expansion towards lower-risk patients. (Curr Probl Cardiol 2023;48:101130.)

Automated summary

This article reviews the ongoing discussion on predictors for permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI), especially in low and medium risk patients. Factors contributing to rhythm abnormalities post TAVI include pre-existing conduction abnormalities, patient-related anatomical factors, and peri-procedural technical factors. Attention should be directed towards modifiable peri-procedural technical factors, particularly as TAVI expands to lower-risk patients.