# Conductiestoornissen en pacemaker na TAVR: risicostratificatie en beheer

*geplaatst 2026-09-05 · Algemeen · Interventional cardiology clinics · doi 10.1016/j.iccl.2026.06.003 · https://hartvaat.nl/2026/10/01/conductiestoornissen-en-pacemaker-na-tavr-risicostratificatie-en-beheer/*

Deze review beschrijft de mechanismen, risicofactoren en het beheer van conductiestoornissen na TAVR. Nieuw opgetreden linkerpaketsvertakkingblok is het meest voorkomend, terwijl hooggradig AV-blok vaak een permanente pacemaker vereist. Risicostratificatie combineert baseline-ECG-afwijkingen, beeldvormingskenmerken en procedurele factoren. Inzicht hierin helpt cardiologen bij het monitoren en managen van patiënten na deze ingreep.

## English: Conduction Disturbances and Pacing after Transcatheter Aortic Valve Replacement: Mechanisms, Risk Stratification, and Management.

This review outlines the mechanisms, risk stratification, and management of conduction disturbances following transcatheter aortic valve replacement (TAVR). New-onset left bundle branch block is the most common complication, while high-grade atrioventricular block frequently necessitates permanent pacemaker implantation. Risk assessment integrates baseline electrocardiographic abnormalities, imaging features, and procedural variables. Understanding these factors enables interventional cardiologists to optimize postprocedural monitoring and pacing strategies.

## Abstract (original, from the publication)

Conduction disturbances are common after transcatheter aortic valve replacement and significantly influence postprocedural management and outcomes. These abnormalities arise from the close anatomic relationship between the aortic annulus and the atrioventricular conduction system, with injury mediated by mechanical compression, edema, ischemia, and delayed remodeling. New-onset left bundle branch block is the most frequent disturbance, while high-grade atrioventricular block often requires permanent pacemaker implantation. Risk stratification is multifactorial and incorporates baseline electrocardiographic abnormalities-particularly right bundle branch block-imaging features such as membranous septum length and left ventricular outflow tract calcification, and procedural factors including implantation depth and valve platform.

Auteurs: Ahmed AlBadri, Stephanie Wang, Cesar Egoavil, Hasan Jilaihawi

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Bron: Interventional cardiology clinics, https://doi.org/10.1016/j.iccl.2026.06.003. Bijgewerkt 2026-08-29T01:12:02Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.