JAMA Network JAMA Cardiology : Mechanisms Underlying Alterations in Cardiac Conduction After Transcatheter Aortic Valve Replacement
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Dec 10, 2025 Alfred E. Buxton, MD, a leading expert in cardiac electrophysiology, and Marie-France Poulin, MD, an interventional cardiology professor, delve into the complexities of cardiac conduction after transcatheter aortic valve replacement. They discuss their study's key findings, particularly the link between pre-existing conditions and the risk of conduction blocks. The duo emphasizes the importance of intracardiac monitoring during TAVR and shares insights on procedural strategies, pacing needs, and the nuances of conduction disturbances, offering a rich understanding for practitioners in the field.
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Continuous EP Monitoring Reveals True Conduction Timing
- Continuous intracardiac and surface ECG recording during TAVR revealed when and what conduction disturbances occur.
- The study aimed to clarify timing and types of blocks to guide monitoring and pacemaker decisions.
Interventionalist Relearns EP Study For Trial
- Marie-France recounts relearning how to perform an EP study to gather richer data during TAVR.
- She emphasized enjoying the study and the unique information it produced.
Some Blocks Originate In The AV Node
- A subset of blocks localized to the AV node, not only the His-Purkinje system, after TAVR.
- Pre-existing right bundle branch block strongly predicted intraprocedural block but not delayed block.