Conduction Abnormalities After Transcatheter Aortic Valve Replacement: Comprehensive Review of Current Literature, Guidelines, and Clinical Practices.

Transcatheter aortic valve replacement (TAVR) offers a minimally invasive alternative to traditional surgical aortic valve replacement (SAVR) for the treatment of severe aortic stenosis. Notably, TAVR was once reserved for patients at high surgical risk but is now a viable option even for those at low surgical risk. Despite the widespread adoption and favorable outcomes of TAVR, this technique presents several challenges, including conduction disturbances such as new-onset left bundle branch block (LBBB) and high-grade atrioventricular (AV) block, which may require permanent pacemaker (PPM) implantation. These complications arise from the close anatomical relationship between the aortic valve and the cardiac conduction system and are influenced by factors such as valve design, implantation depth, and individual anatomical variations. This review aims to explore the structural and physiological intricacies of the aortic valve and conduction system. Additionally, this review explores pre-procedural risk stratification, monitoring protocols, and emerging strategies to mitigate these complications and enhance procedural safety and long-term patient outcomes.