Abstract 20252: Use of Ambulatory Event Monitoring in Identifying Patients With Delayed Presentation of High-Grade Atrioventricular Block Following Transcatheter Aortic Valve Replacement

Introduction: Delayed high-grade atrioventricular block (H-AVB) following transcatheter aortic valve replacement (TAVR) has been reported, but identification of such patients post-discharge (DC) has not been well studied. We assessed the utility of ambulatory event monitoring (AEM) in identifying such patients and risk factors. Methods: Patients undergoing index TAVR at our institution from October 2016-May 2017 without a preexisting pacing device and without pre-discharge H-AVB necessitating permanent pacemaker (PPM) implantation were discharged with 30-day AEM. Baseline, procedural, and follow-up data were collected and compared among those with and without subsequent need for post-discharge PPM. Results: Among 59 patients undergoing TAVR, 11 had prior PPM or ICD, and 6 required pre-DC PPM implant for H-AVB; 40 were discharged with 30-day AEM. Six (15%) developed H-AVB (3 Mobitz II 2nd degree AVB, 3 complete AVB) at a median (range) of 5 (4-24) days post-TAVR. There was no statistically significant diff...