Bradyarrhythmias Detected by Extended Rhythm Recording in Patients Undergoing Transcatheter Aortic Valve Replacement (BRADY-TAVR Study)

ABSTRACTS: Background Bradyarrhythmias leading to permanent pacemaker (PPM) continue to be a complication after Transcatheter Aortic Valve Replacement (TAVR) Objectives To assess the prevalence of bradyarrhythmias using ECG extended rhythm recording among patients pre and post TAVR and whether they can predict the need for PPM Methods This was a prospective single center study in patients undergoing TAVR. Patients received an ECG-patch for 2 weeks pre, immediately post, and 2-3 months after TAVR. Caring physicians were blinded to the results of the patch except when predefined urgent arrhythmias were detected. The main outcome was the need for PPM implantation after TAVR. Results We enrolled 110 patients of whom 96 underwent TAVR and were included in the final analysis. Bradyarrhythmias, defined as a pause ≥ 3 seconds, occurred in 5.2%, 12.7%, and 7% of patients pre-, immediately post-, and 2-3 months post- TAVR respectively. PPM implantation occurred in 12 (12.5%) patients of whom 9 (9.4%) underwent implantation during their index hospitalization while 3 (3.1%) required implantation post-discharge for indications other than heart block. No patients required PPM after receiving ECG-patch 2-3 months post-TAVR. Significant baseline predictors for the need for PPM included the presence of right bundle-branch block and increased QRS duration. Bradyarrhythmias detected by ECG-patch did not predict the need for a PPM at either index hospitalization or follow-up period. Conclusions Bradyarrhythmias are common and can be detected with extended ECG monitoring before and after TAVR, however, in our study did not predict the need for a PPM after TAVR.