Castro-Mejía, Alex FAmat-Santos, IgnacioOrtega-Armas, Maria EBaz, Jose AMoreno, RaúlDiaz, Jose FTravieso, AlejandroJimenez-Quevedo, PilarSantos-Martínez, SandraMcInerney, AngelaGaleote, GuillermoDíaz, Victor Alfonso JimenezGarrido, Jessica RoaTirado-Conte, GabrielaBarrero, AlejandroMarroquin, LuisNuñez-Gil, IvanGonzalo, NievesFernandez-Ortiz, AntonioEscaned, JavierNombela-Franco, Luis2023-05-032023-05-032022-05-10http://hdl.handle.net/10668/22263High degree cardiac conduction disturbances (HDCD) remain a major complication after transcatheter aortic valve replacement (TAVR), especially with self-expandable valves (SEV). Our aim was to investigate peri-procedural and in-hospital modification of atrioventricular and intracardiac conduction associated to new generation SEV implantation, and the development of new HDCD resulting in permanent pacemaker implantation (PPM) in patients undergoing TAVR. Three-hundred forty-four consecutive patients with severe aortic stenosis who underwent TAVR with a new generation SEV [Evolut-R/Pro (n = 130), Acurate-neo (n = 79), Portico (n = 75) and Allegra (n = 60)] were included. An analysis of baseline, post-TAVR and pre-discharge ECG and procedural aspects were centrally performed. A significant increase in baseline PR interval (169.6 ± 28.2 ms) and QRS complex width (101.7 ± 25.9 ms) was noted immediately post-TAVR (188.04 ± 34.49; 129.55 ± 30.02 ms), with a partial in-hospital reversal (179.4 ± 30.1; 123.06 ± 30.94 ms), resulting in a net increase at hospital discharge of 12.6 ± 38.8 ms and 21.4 ± 31.6 ms (p  New generation self-expanding aortic valves were associated with a significant increase in PR and QRS interval at hospital discharge leading to a very high rate of HDCD. While valve recapture and implantation depth were independent predictors for the occurrence of HDCD, use of Accurate-Neo valve was a protective factor.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Electrocardiographic disturbancesPacemakerSelf-expanding aortic valvesTranscatheter aortic valve replacementAortic ValveAortic Valve StenosisCardiac Conduction System DiseaseHeart Valve ProsthesisHumansProsthesis DesignRisk FactorsTranscatheter Aortic Valve ReplacementTreatment Outcomeresearch article35550389open access10.1016/j.ijcard.2022.05.0141874-1754https://doi.org/10.1016/j.ijcard.2022.05.014