Leadless Pacing for Delayed Heart Block After Transcatheter Tricupid Valve Replacement.

Authors

Abby E Geerlings, Krystien V V Lieve, Anna A C Velraeds, Louise R A Olde Nordkamp, Reinoud E Knops, Marije M Vis, Marcel A M Beijk, Berto J Bouma, Jan Baan

Published in

JACC. Case reports. Pages 109813. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

Transcatheter tricuspid valve replacement (TTVR) is a minimally invasive treatment for severe tricuspid regurgitation. However, atrioventricular block (AVB) requiring permanent pacemaker implantation occurs in 12.0% to 13.3% of patients without a pacemaker.
An 81-year-old man presented 7 days after TTVR with dyspnea and dizziness. Electrocardiography showed alternating AVB, and monitoring indicated a transient episode of complete AVB, suggesting a premonitory sign of delayed conduction disease after EVOQUE implantation. A leadless pacemaker (Micra VR) was implanted to avoid interference with the prosthetic tricuspid valve. The procedure was uneventful, and follow-up showed stable pacemaker parameters and preserved prosthetic valve function.
This case review summarizes conduction disturbances after TTVR, pacing strategies, and postprocedural monitoring. In the absence of recommendations, pacemaker selection should be individualized, with leadless pacing representing a valve-sparing strategy.
Delayed AVB may occur after TTVR, with an alternating AVB as a premonitory sign. Leadless pacemakers offer a valve-sparing pacing option.

PMID:
42610994
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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