Predicting the Post-TAVR Need for Permanent Pacemakers

Some patients undergoing transcatheter aortic-valve replacement (TAVR) later need permanent pacemakers (PPMs). Although predictors of PPM implantation are known (preexisting right or induced left bundle-branch block [RBBB and LBBB, respectively], heart block during TAVR, and use of self-expanding valves), the indications for PPM implantation are unclear. Investigators in a two-center prospective study tested the usefulness of rapid atrial pacing (RAP), using the right ventricular catheter placed during TAVR, in 284 patients.

Patients with periprocedural complete heart block (CHB) or atrial fibrillation (AF) were excluded. Immediately after TAVR, interventionalists increased pacing rates to 120 beats/minute or until atrioventricular (AV) Wenc…