When would you consider discharging post-TAVR patients on outpatient mobile cardiac telemetry with baseline right bundle branch block without further signs of conduction abnormalities 24-48 hours after the procedure, given risk of developing later-onset conduction abnormalities?
And if so, what is a reasonable length of time for outpatient cardiac monitoring?
Answer from: at Academic Institution
I agree with Dr. @Ben-Dor's comments. Preexisting RBBB is one of the most potent predictors for need development of significant AVB warranting a pacemaker post-TAVR and this represents roughly 10% of patients undergoing the procedure. Though there have been expert panel recommendations (Rodés...
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Answer from: at Community Practice
Indeed, patients with pre-existing RBBB are associated with a higher risk of pacemaker implantation at 30 days (Auffret et al., PMID 28734885). Development of complete heart block, however, remains unpredictable with documented late events. Because of that, there exists no clear guidelines on the ma...