DETECTION OF DELAYED HIGH-GRADE ATRIOVENTRICULAR BLOCK AFTER TAVI USING A SINGLE-LEAD PATCH MONITOR IN A RESOURCE-LIMITED SETTING: A CASE REPORT

Abstract

Background. Transcatheter aortic valve implantation (TAVI) is widely used in patients with severe aortic stenosis but carries a risk of delayed conduction disturbances. Continuous ambulatory ECG monitoring may facilitate early detection; however, access to multichannel Holter systems remains limited in some regions.
Case presentation. We report a case of delayed progression of atrioventricular (AV) conduction disturbances after TAVI. Due to the limited availability of conventional multichannel Holter systems, a single-lead patch ECG recorder was used. The device successfully detected progression from first-degree AV block to high-grade and complete AV block, leading to timely permanent pacemaker implantation.
Results and Discussion. This case demonstrates the development of delayed high-grade atrioventricular conduction disturbances after TAVI, despite an initially uneventful postoperative course. Mechanical interaction between the prosthetic valve and the conduction system may lead to progressive injury and delayed bradyarrhythmias.
A key aspect of this case is the use of a single-lead patch ECG recorder, which can effectively detect clinically significant conduction disturbances and guide management decisions.
Conclusion. This case highlights the clinical utility of single-lead patch ECG monitoring in detecting clinically significant arrhythmias after TAVI, particularly in resource-limited settings. The recent introduction of wearable Holter technology in Kazakhstan enables prolonged monitoring and may improve the detection of delayed conduction disturbances.