References
1. Schwarz F, Baumann P, Manthey J, et al. The effect of aortic valve replacement on survival. Circulation 1982;66:1105-10.
2. Alivizatos PA. Dwight Emary Harken, MD, an all-American surgical giant: Pioneer cardiac surgeon, teacher, mentor. Baylor University Medical Center Proceedings 2018;31:554-7.
3. Eveborn GW, Schirmer H, Heggelund G, Lunde P, Rasmussen K. The evolving epidemiology of valvular aortic stenosis. The Tromsø Study. Heart 2013;99:396-400.
4. Gannon PG, Sellers RD, Kanjuh VI, Edwards JE, Lillehei CW. Complete heart block following replacement of the aortic valve. Circulation 1966;33:I152-I61.
5. Rosato S, Biancari F, D’Errigo P, et al. One-Year Outcomes after Surgical versus Transcatheter Aortic Valve Replacement with Newer Generation Devices. Journal of Clinical Medicine 2021;10:3703.
6. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. New England Journal of Medicine 2016;374:1609-20.
7. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. New England Journal of Medicine 2019;380:1695-705.
8. Wang T, Ou A, Xia P, Tian J, Wang H, Cheng Z. Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: a systematic review and meta-analysis  Journal of Cardiac Surgery 2021.
9. Kawashima T, Sato F. Visualizing anatomical evidences on atrioventricular conduction system for TAVI. International Journal of Cardiology 2014;174:1-6.
10. Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert Panel. J Am Coll Cardiol 2019;74:1086-106.
11. Ferreira T, Da Costa A, Cerisier A, et al. Predictors of high‐degree conduction disturbances and pacemaker implantation after transcatheter aortic valve replacement: Prognostic role of the electrophysiological study. Pacing and Clinical Electrophysiology 2021;44:843-55.
12. Nazif TM, Dizon M, José, Hahn RT, et al. Predictors and Clinical Outcomes of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement. JACC: Cardiovascular Interventions 2015;8:60-9.
13. Clementy N, Bisson A, Bodin A, et al. Outcomes associated with pacemaker implantation following transcatheter aortic valve replacement: A nationwide cohort study. Heart Rhythm 2021.
14. Cahill TJ, Prendergast BD. Infective endocarditis. The Lancet 2016;387:882-93.
15. Lalani T. In-Hospital and 1-Year Mortality in Patients Undergoing Early Surgery for Prosthetic Valve Endocarditis. JAMA Internal Medicine 2013;173:1495.
16. Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction. Circulation 2003;107:2932-7.
17. Regueiro A, Abdul-Jawad Altisent O, Del Trigo M, et al. Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement. Circulation: Cardiovascular Interventions 2016;9:e003635.
18. Curtis AB, Worley SJ, Adamson PB, et al. Biventricular Pacing for Atrioventricular Block and Systolic Dysfunction. New England Journal of Medicine 2013;368:1585-93.
19. Choi YS, Yin RT, Pfenniger A, et al. Fully implantable and bioresorbable cardiac pacemakers without leads or batteries. Nature Biotechnology 2021;39:1228-38.
20. Kaplan RM, Yadlapati A, Cantey EP, et al. Conduction recovery following pacemaker implantation after transcatheter aortic valve replacement. Pacing and Clinical Electrophysiology 2018.
21. Ream K, Sandhu A, Valle J, et al. Ambulatory Rhythm Monitoring to Detect Late High-Grade Atrioventricular Block Following Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology 2019;73:2538-47.
22. Cohen Y, Zisberg A, Chayat Y, et al. Walking for Better Outcomes and Recovery: The Effect of WALK-FOR in Preventing Hospital-Associated Functional Decline Among Older Adults. The Journals of Gerontology: Series A 2019;74:1664-70.
1. Stewart BF, Siscovick D, Lind BK, et al. Clinical Factors Associated With Calcific Aortic Valve Disease. Journal of the American College of Cardiology 1997;29:630-4.
2. Alivizatos PA. Dwight Emary Harken, MD, an all-American surgical giant: Pioneer cardiac surgeon, teacher, mentor. Baylor University Medical Center Proceedings 2018;31:554-7.
3. Eveborn GW, Schirmer H, Heggelund G, Lunde P, Rasmussen K. The evolving epidemiology of valvular aortic stenosis. The Tromsø Study. Heart 2013;99:396-400.
4. Gannon PG, Sellers RD, Kanjuh VI, Edwards JE, Lillehei CW. Complete heart block following replacement of the aortic valve. Circulation 1966;33:I152-I61.
5. Rosato S, Biancari F, D’Errigo P, et al. One-Year Outcomes after Surgical versus Transcatheter Aortic Valve Replacement with Newer Generation Devices. Journal of Clinical Medicine 2021;10:3703.
6. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. New England Journal of Medicine 2016;374:1609-20.
7. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. New England Journal of Medicine 2019;380:1695-705.
8. Wang T, Ou A, Xia P, Tian J, Wang H, Cheng Z. Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: a systematic review and meta-analysis  Journal of Cardiac Surgery 2021.
9. Kawashima T, Sato F. Visualizing anatomical evidences on atrioventricular conduction system for TAVI. International Journal of Cardiology 2014;174:1-6.
10. Rodés-Cabau J, Ellenbogen KA, Krahn AD, et al. Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement: JACC Scientific Expert Panel. J Am Coll Cardiol 2019;74:1086-106.
11. Ferreira T, Da Costa A, Cerisier A, et al. Predictors of high‐degree conduction disturbances and pacemaker implantation after transcatheter aortic valve replacement: Prognostic role of the electrophysiological study. Pacing and Clinical Electrophysiology 2021;44:843-55.
12. Nazif TM, Dizon M, José, Hahn RT, et al. Predictors and Clinical Outcomes of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement. JACC: Cardiovascular Interventions 2015;8:60-9.
13. Clementy N, Bisson A, Bodin A, et al. Outcomes associated with pacemaker implantation following transcatheter aortic valve replacement: A nationwide cohort study. Heart Rhythm 2021.
14. Cahill TJ, Prendergast BD. Infective endocarditis. The Lancet 2016;387:882-93.
15. Lalani T. In-Hospital and 1-Year Mortality in Patients Undergoing Early Surgery for Prosthetic Valve Endocarditis. JAMA Internal Medicine 2013;173:1495.
16. Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction. Circulation 2003;107:2932-7.
17. Regueiro A, Abdul-Jawad Altisent O, Del Trigo M, et al. Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement. Circulation: Cardiovascular Interventions 2016;9:e003635.
18. Curtis AB, Worley SJ, Adamson PB, et al. Biventricular Pacing for Atrioventricular Block and Systolic Dysfunction. New England Journal of Medicine 2013;368:1585-93.
19. Choi YS, Yin RT, Pfenniger A, et al. Fully implantable and bioresorbable cardiac pacemakers without leads or batteries. Nature Biotechnology 2021;39:1228-38.
20. Kaplan RM, Yadlapati A, Cantey EP, et al. Conduction recovery following pacemaker implantation after transcatheter aortic valve replacement. Pacing and Clinical Electrophysiology 2018.
21. Ream K, Sandhu A, Valle J, et al. Ambulatory Rhythm Monitoring to Detect Late High-Grade Atrioventricular Block Following Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology 2019;73:2538-47.
22. Cohen Y, Zisberg A, Chayat Y, et al. Walking for Better Outcomes and Recovery: The Effect of WALK-FOR in Preventing Hospital-Associated Functional Decline Among Older Adults. The Journals of Gerontology: Series A 2019;74:1664-70.
Figure. ECG and electrophysiology recordings from a 76 year old woman who underwent TAVR with an Edwards S3 valve. Post-TAVR ECGs showed PR prolongation of 30 ms and a left bundle branch block (LBBB). At electrophysiology study, Panel A shows the LBBB was intermittent in sinus rhythm. In panel B, there is no difference in HV interval between the first beat with LBBB and the second beat without LBBB (HV was 55 ms). Panel C shows 6 beats of atrial pacing at 100 bpm with normal conduction (no LBBB). When pacing stops, sinus rhythm resumes at a much lower rate and the LBBB resumes. This phenomenon of bradycardia-dependent LBBB is known as phase 4 block. Based on these findings a pacemaker was not recommended.