Extremely Late Complete AV Block After TAVR: ECG Clues and Correction With Left Bundle Branch Pacing.
| Title: | Extremely Late Complete AV Block After TAVR: ECG Clues and Correction With Left Bundle Branch Pacing. |
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| Authors: | Kieu ND; Department of Arrhythmology, Cho Ray Hospital, Ho Chi Minh city, Vietnam.; Tran CD; Department of Arrhythmology, Cho Ray Hospital, Ho Chi Minh city, Vietnam.; Tran LUP; Department of Arrhythmology, Cho Ray Hospital, Ho Chi Minh city, Vietnam.; Nguyen HTM; Interventional Cardiology Department, Cho Ray Hospital, Ho Chi Minh city, Vietnam.; Vo TD; Department of Arrhythmology, Cho Ray Hospital, Ho Chi Minh city, Vietnam. |
| Source: | Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2026 Mar 17. Date of Electronic Publication: 2026 Mar 17. |
| Publication Model: | Ahead of Print |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Futura Pub. Co Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978- |
| Abstract: | Background: Transcatheter Aortic Valve Replacement (TAVR) carries a notable risk of conduction system injury. While most atrioventricular (AV) blocks occur early, predictors of late-onset AV block and its latest timing remain uncertain.; Case Summary: A 63-year-old man who developed complete AV block 17 months after TAVR (Evolut-R 29 mm). Serial electrocardiograms showed progressive warning signs: left anterior fascicular block at one month, complete left bundle branch block (LBBB) with first-degree AV block at one year, and, ultimately, complete AV block. Electrophysiological study demonstrated AH and HV intervals of 75 ms and 78 ms, respectively. Prolonged ambulatory monitoring revealed intermittent high-grade AV block. The patient underwent left bundle branch pacing (LBBP), which provided physiologic ventricular activation and corrected the conduction abnormalities; symptoms resolved and pacing parameters remained stable on follow-up.; Conclusion: Complete AV block can present extremely late after TAVR. Even subtle ECG abnormalities should be regarded as warning signs and prompt prolonged rhythm surveillance. LBBP is a physiologic pacing strategy that can both ensure reliable pacing and restore ventricular conduction.; (© 2026 Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: ECG warning signs; TAVR; conduction system pacing; late‐onset complete AV block; left bundle branch pacing |
| Entry Date(s): | Date Created: 20260317 Latest Revision: 20260317 |
| Update Code: | 20260317 |
| DOI: | 10.1111/pace.70215 |
| PMID: | 41840980 |
| Database: | MEDLINE |
Case Reports; Journal Article