This Week in Cardiology

Dec 12 2025 This Week in Cardiology

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Dec 12, 2025
Explore a fascinating study on post-TAVI atrioventricular block revealing distinct patterns before and after the procedure. Delve into a public service announcement urging collaboration between structural heart teams and electrophysiologists. Discover important insights on revascularization outcomes, showing women fare better with CABG over PCI. Finally, John critiques a CTO-PCI trial, expressing skepticism about its clinical value. Tune in for a glimpse of the top stories coming in 2025!
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INSIGHT

Distinct Mechanisms For TAVR Heart Block

  • AV conduction injury after TAVR arises from distinct mechanisms that differ for intra-procedural and delayed block.
  • Electrophysiologic measurements during TAVR can clarify mechanism and guide pacing decisions.
INSIGHT

Immediate Versus Delayed Block Have Different Predictors

  • Intra-procedural AV block is often persistent and highly pacing-dependent, while delayed block is usually paroxysmal with low pacing burden.
  • Different predictors (membranous septum length, calcium burden, HV interval, PR changes) separate immediate versus delayed risk.
ADVICE

Use HV And PR To Guide Pacemaker Decisions

  • Use end-of-procedure HV intervals combined with PR measurements to risk-stratify for delayed heart block.
  • Consider pacemaker implantation selectively when HV >80 ms and PR prolongation coexist rather than relying on ECG alone.
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