skip to main content

Conduction Disturbance Post-TAVI — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateValvular Heart DiseaseConduction Disturbance Post-TAVIEECC

A 78-year-old woman with severe aortic stenosis undergoes TAVI. Post-procedure, she develops a new left bundle branch block (LBBB) with a PR interval of 280 ms. She is haemodynamically stable. What is the risk and recommended monitoring?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — New LBBB with first-degree AV block post-TAVI confers a risk of progression to complete heart block; continuous ECG monitoring for at least 48 hours and consideration of permanent pacemaker if high-degree AV block develops

New-onset LBBB is the most common conduction disturbance after TAVI (occurring in 5-30% depending on valve type), caused by mechanical compression of the His bundle and left bundle branch by the prosthesis at the membranous septum. While isolated new LBBB often resolves or remains stable, combination with first-degree AV block (prolonged PR) or pre-existing RBBB significantly increases the risk of progression to complete heart block. The 2025 ESC VHD Guidelines recommend continuous ECG monitoring for at least 24-48 hours post-TAVI for new conduction disturbances. Permanent pacemaker implantation is indicated for persistent high-degree AV block or alternating bundle branch block. Ambulatory Holter monitoring before discharge may identify intermittent high-degree block.

Reference: ESC/EACTS (2025): Guidelines for the Management of Valvular Heart Disease