{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:33:02Z","timestamp":1790091182052,"version":"4.0.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The prognostic value of rapid atrial pacing (RAP)-induced Wenckebach atrioventricular block (W-AVB) as a diagnostic test for predicting permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) remains unclear and requires further validation. The objective of this study was to evaluate the predictive value of RAP-induced W-AVB for PPI and sudden cardiac death within 30 days post-TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This prospective, investigator-initiated, multicenter study (PACE-TAVR) included 640 patients undergoing TAVR across 12 centers. RAP was performed before and after TAVR to assess for W-AVB. Using negative predictive values and negative likelihood ratios, the predictive value of W-AVB was evaluated for the primary end point: sudden cardiac death or guideline-based indications for PPI, including complete AVB or alternating bundle branch block (Class I), and preexisting conduction disturbances with new ECG changes, new-onset left bundle branch block, a positive electrophysiology study, or sinus node dysfunction (Class II).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      RAP was successfully performed post-TAVR in 556 patients, with RAP-induced W-AVB observed in 192 (34.5%). W-AVB was associated with baseline conduction disturbances, amiodarone use, pre-TAVR RAP-induced W-AVB, and anesthesia type. The primary end point was more frequent in patients with W-AVB (15.6% versus 9.3%; odds ratio, 1.80 [95% CI, 1.06\u20133.04];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.029). However, the absence of W-AVB had a negative predictive value of only 90.7% and a poor negative likelihood ratio (0.79). The test\u2019s utility declined in subgroups at high risk for PPI, including self-expanding valve recipients (odds ratio, 1.47 [95% CI, 0.84\u20132.58]; negative predictive value, 88.4%; negative likelihood ratio, 0.86) and patients with a baseline or new left bundle branch block (odds ratio, 1.14 [95% CI, 0.54\u20132.42]; negative predictive value, 81.3%; negative likelihood ratio, 0.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>RAP-induced W-AVB demonstrates limited utility in predicting post-TAVR PPI or sudden cardiac death, particularly in patients at high risk for PPI. Clinicians should be cautious when using this test for post-TAVR rhythm management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT05278585.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.016145","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:00:36Z","timestamp":1774515636000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid Atrial Pacing-Induced Wenckebach Atrioventricular Block: A Poor Predictor of Permanent Pacemaker Need Post-TAVR"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct05278585","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-6306","authenticated-orcid":true,"given":"Emmanuel","family":"De Cock","sequence":"first","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium (E.D.C., E.C., J.-B.l.P.d.W., J.V.d.H., I.B.)."},{"name":"Department of Cardiology, Ghent University Hospital, Belgium (E.D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9892-5420","authenticated-orcid":true,"given":"Tom","family":"Adriaenssens","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven, Belgium (T.A., C.D., P.L.)."},{"name":"Department of Cardiovascular Medicine, University Hospitals Leuven, Belgium (T.A., C.D., P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Stammen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Delta, Roeselare, Belgium (F. Stammen, M. Vanhaverbeke)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3050-5221","authenticated-orcid":true,"given":"Marc","family":"Vanderheyden","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OLV Aalst, Belgium (M. Vanderheyden)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5255-1443","authenticated-orcid":true,"given":"Christophe","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven, Belgium (T.A., C.D., P.L.)."},{"name":"Department of Cardiovascular Medicine, University Hospitals Leuven, Belgium (T.A., C.D., P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4385-7069","authenticated-orcid":true,"given":"Maarten","family":"Vanhaverbeke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Delta, Roeselare, Belgium (F. Stammen, M. Vanhaverbeke)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Ferdinande","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Oost-Limburg, Genk, Belgium (B.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Pirlet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Citadelle Liege, Belgium (C.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint-Luc Bouge, Namur, Belgium (F. Simon)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1152-9594","authenticated-orcid":true,"given":"Bert","family":"Vandeloo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centrum voor Hart- en Vaatziekten (CHVZ), Vrije Universiteit Brussel (VUB), Universtair Ziekenhuis Brussel (UZ Brussel), Belgium (B.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Lesizza","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven, Belgium (T.A., C.D., P.L.)."},{"name":"Department of Cardiovascular Medicine, University Hospitals Leuven, Belgium (T.A., C.D., P.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3940-3072","authenticated-orcid":true,"given":"Liesbeth","family":"Rosseel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, ASZ Aalst, Belgium (L.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4667-9181","authenticated-orcid":true,"given":"Adel","family":"Aminian","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Belgium (A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Cardiology, ZAS Middelheim, Antwerp, Belgium (B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0673-5787","authenticated-orcid":true,"given":"Fr\u00e9d\u00e9ric","family":"De Vroey","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Grand H\u00f4pital de Charleroi, Belgium (F.D.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3171-1425","authenticated-orcid":true,"given":"Emma","family":"Christiaen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium (E.D.C., E.C., J.-B.l.P.d.W., J.V.d.H., I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1737-1353","authenticated-orcid":true,"given":"Jean-Beno\u00eet","family":"le Polain de Waroux","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium (E.D.C., E.C., J.-B.l.P.d.W., J.V.d.H., I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5116-2139","authenticated-orcid":true,"given":"Jan","family":"Van der Heyden","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium (E.D.C., E.C., J.-B.l.P.d.W., J.V.d.H., I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1754-9334","authenticated-orcid":true,"given":"Ian","family":"Buysschaert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium (E.D.C., E.C., J.-B.l.P.d.W., J.V.d.H., I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx785"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.12.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab364"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.07.014"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.01.215"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7458.168"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.09.003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014446"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.10.023"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2677"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30817"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2016:34:2"},{"key":"e_1_3_3_14_2","volume-title":"Electrophysiologic Study Interpretation","author":"Koulouris S","year":"2025","unstructured":"Koulouris S, Cascella M. 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StatPearls; 2025."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.07.012"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.06.014"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315967"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.125.016145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:00:36Z","timestamp":1780509636000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.125.016145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.125.016145"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.125.016145","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}