# Conduction abnormalities after TAVI and their role in patient management: a systematic review

## TL;DR

This paper reviews how TAVI can cause heart conduction issues and suggests monitoring strategies to determine if patients need a pacemaker.

## Contribution

The study identifies key ECG predictors of pacemaker implantation after TAVI and proposes a standardized monitoring protocol.

## Key findings

- Pre-existing right bundle branch block and prolonged ECG intervals predict the need for pacemaker implantation.
- Common post-TAVI ECG changes include left bundle branch block and QRS widening.
- Systematic ECG monitoring is crucial for early detection of conduction abnormalities after TAVI.

## Abstract

Transcatheter aortic valve implantation (TAVI) is associated with a relatively high incidence of permanent pacemaker implantation (PPM-I). We aimed to evaluate the existing literature on electrocardiographic (ECG) changes before and after TAVI, identify predictors for PPM-I, and suggest a standardized post-TAVI ECG monitoring protocol.

A systematic literature review was conducted across multiple databases, including PubMed, Web of Science, and JSTOR, to identify studies published between 2001 and 2024.

From an initial pool of 24,170 records, 17 studies met the inclusion criteria. Pre-existing right bundle branch block and significant prolongation of ECG intervals were identified as strong predictors of PPM-I. Following TAVI, new-onset left bundle branch block, prolonged PR interval, and QRS complex widening were the most common ECG changes.

Systematic periprocedural ECG monitoring during TAVI is of paramount importance for the early recognition of conduction abnormalities (CAs) that predict the need for PPM-I.

Created in “Biorender” (https://www.biorender.com/).Infographic summarizes pre- and post-TAVI ECG changes, monitoring, and outcomes over four stages: Pre-TAVI, TAVI procedure, immediate post-TAVI, and thirty days. It lists pre-TAVI risk factors, post-TAVI ECG changes, and provides guidelines for clinical outcomes and appropriate monitoring strategies with related icons.

Created in “Biorender” (https://www.biorender.com/).