Extremely Late Complete AV Block After TAVR: ECG Clues and Correction With Left Bundle Branch Pacing.

Pacing Clin ElectrophysiolMar 17, 2026 (epub)
Case ReportCardiologyOpen access

Ngoc Dung Kieu, Cao Dat Tran, Le Uyen Phuong Tran et al.

✦ AI-curated · Sources linked

Case in brief

A 63-year-old man developed complete atrioventricular block 17 months after transcatheter aortic valve replacement with an Evolut-R 29 mm valve. Serial ECGs had shown progressive conduction abnormalities, from left anterior fascicular block to complete left bundle branch block with first-degree AV block. Electrophysiological testing showed AH and HV intervals of 75 ms and 78 ms, and prolonged ambulatory monitoring detected intermittent high-grade block. Left bundle branch pacing provided physiologic ventricular activation and corrected the conduction abnormalities; symptoms resolved and pacing parameters remained stable at follow-up.

What made this case unusual

The complete AV block occurred 17 months after TAVR, following progressive ECG changes that preceded the clinical presentation.

Diagnostic / clinical pearl

Progressive ECG abnormalities after TAVR may precede late high-grade AV block; this case supports prolonged rhythm surveillance when such changes are present.

Why it matters

Left bundle branch pacing both provided reliable pacing and corrected ventricular conduction abnormalities in this patient.

Source

PubMed · PMID 41840980Free full text on PubMed Central

Published in Pacing Clin Electrophysiol. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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