High-degree atrioventricular block (HAVB) or complete heart block (CHB) is a common complication associated with transcatheter aortic valve replacement (TAVR). However, some patients with HAVB/CHB recover with time. The results of electrophysiological studies (EPSs) using permanent pacemaker implantation (PPI) in patients with suspicious HAVB/CHB are considered controversial.

This study aimed to evaluate whether HAVB/CHB induction at the bedside using a temporary pacemaker can predict recurrence in patients who had recovered from HAVB/CHB after TAVR.

We enrolled a total of 11 patients who had recovered from HAVB/CHB and evaluated their electrophysiology using right ventricular pacing and/or procainamide administration.

HAVB/CHB induction was positive. Three patients tested positive for HAVB/CHB, whereas 8 tested negative. The ejection fraction and the interval between HAVB/CHB onset and EPS were found to be significant. HAVB/CHB positive patients underwent PPI. A patient with a balloon-expandable valve tested positive just before recovery of CHB, but tested negative 5 days later and was included in the negative group. The 4 patients who tested negative received a cardiovascular implantable electric device (CIED). We observed HAVB/CHB in 2 patients who had previously tested positive after 3 months. Among those who tested negative, those with CIED had no HAVB/CHB, and others showed neither HAVB/CHB on electrocardiogram nor experienced syncope or sudden death.

Our EPS revealed that HAVB/CHB induction may predict HAVB/CHB recurrence after TAVR. Valve type and EPS timing may affect the results.

高度房室传导阻滞 (HAVB) 或完全性心脏传导阻滞 (CHB) 是与经导管主动脉瓣置换术 (TAVR) 相关的常见并发症。然而，一些 HAVB/CHB 患者会随着时间的推移而康复。在可疑 HAVB/CHB 患者中使用永久起搏器植入 (PPI) 的电生理学研究 (EPS) 的结果被认为是有争议的。

本研究旨在评估使用临时起搏器在床边诱导 HAVB/CHB 是否可以预测 TAVR 后从 HAVB/CHB 中恢复的患者的复发。

我们共招募了 11 名从 HAVB/CHB 中康复的患者，并使用右心室起搏和/或普鲁卡因胺评估了他们的电生理学。

HAVB/CHB 诱导呈阳性。3 名患者的 HAVB/CHB 检测呈阳性，而 8 名患者检测呈阴性。发现射血分数和 HAVB/CHB 发病与 EPS 之间的间隔是显着的。HAVB/CHB 阳性患者接受 PPI。一名装有球囊扩张瓣膜的患者在 CHB 恢复前检测为阳性，但在 5 天后检测为阴性，并被包括在阴性组中。测试为阴性的 4 名患者接受了心血管植入式电子设备 (CIED)。我们在 2 名之前在 3 个月后检测呈阳性的患者中观察到了 HAVB/CHB。在检测结果为阴性的患者中，CIED 患者没有 HAVB/CHB，其他人在心电图上既没有 HAVB/CHB，也没有晕厥或猝死。

我们的 EPS 显示 HAVB/CHB 诱导可能预测 TAVR 后 HAVB/CHB 的复发。阀门类型和 EPS 正时可能会影响结果。