Conduction Disturbances After Transcatheter Aortic Valve Replacement: An Update on Epidemiology, Preventive Strategies, and Management | JACC

Hosts Mitsuaki Sawano, MD, and Nobuhiro Ikemura, MD, welcome Yuichiro Mori, MD, MPH, a physician-scientist at Kyoto University, to discuss his ACC.25 poster presentation on biomarker-based pre-heart failure screening using NT-proBNP, conducted in a rural Japanese city in Hokkaido. Drawing from a screening cohort of 1,585 individuals aged 40–74 in Furano, the study integrated NT-proBNP testing into Japan’s routine general health checkups. Dr. Mori shares key takeaways from the study and emphasizes how even single-site efforts, when well-structured and strategically communicated, can gain recognition at major global meetings like ACC.

Listen to the editor's page of the April 14th JACC issue for a discussion about the staggering toll of cardiovascular disease on Black Americans, revealing nearly 800,000 excess deaths and 23.7 million years of potential life lost over two decades. Join Editor-in-Chief Harlan Krumholz as he explores the systemic roots of these disparities and calls for urgent, collective action to turn data into justice.

In this episode, Dr. Valentin Fuster reviews groundbreaking studies from the April 22, 2025 issue of JACC, covering key findings in valve replacement, pregnancy-related cardiovascular risk, and post-MI therapy. Plus, two cutting-edge reviews explore atrial fibrillation ablation and conduction disturbances after transcatheter valve procedures.

In this podcast, Dr. Valentin Fuster reviews a pivotal study comparing the five-year outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic stenosis. The study found that both treatments yielded similar mortality and stroke rates, reinforcing TAVR’s non-inferiority to surgery, though long-term outcomes in younger patients and the impact of pacemaker implantation remain areas of concern.

In this podcast, Dr. Valentin Fuster discusses a study on pre-pregnancy obesity and its long-term effects on pregnancy outcomes and cardiovascular health later in life. The research highlights how pre-pregnancy obesity and overweight increase the risk of gestational diabetes, hypertension, and future cardiovascular disease, underscoring the need for early weight management and more research on treatments like GLP-1 receptor agonists.

In this podcast, Dr. Valentin Fuster discusses a pivotal study on the benefits of early acetamide initiation combined with statins after a myocardial infarction, showing improved cardiovascular outcomes. The study’s findings suggest that early combination therapy reduces the risk of major cardiovascular events, urging healthcare pathways to adopt this approach as standard practice for better patient outcomes.

In this podcast, Dr. Valentin Fuster reviews the impact of catheter ablation on atrial fibrillation progression, summarizing a state-of-the-art article published in JACC. It explores how catheter ablation modifies the disease's mechanisms, reduces progression to persistent atrial fibrillation, and improves cardiovascular outcomes, suggesting that earlier intervention leads to better long-term results.

In this podcast, Dr. Valentin Fuster presents a comprehensive review of conduction disturbances following transcatheter aortic valve replacement (TAVR), highlighting key factors that contribute to the need for permanent pacemaker implantation. The discussion covers current management strategies, risks, and future perspectives, emphasizing the need for improved prediction methods and the evolving role of ambulatory monitoring and physiological pacing techniques.

Hosts Mitsuaki Sawano, MD, and co-host Satoshi Shoji, MD, welcome Kenji Inoue, MD, to discuss the DROP-Asian ACS study—a multicenter trial evaluating the 0/1-hour algorithm for chest pain assessment across 12 hospitals in five Asian countries presented as a Late Breaking Clinical Trial at the ACC.25. Dr. Inoue shares key findings from this cluster-randomized trial of nearly 4,000 patients, highlighting the algorithm’s practicality in Asia’s diverse healthcare settings. Despite regional differences, the 0/1-hour approach—requiring only two high-sensitivity troponin measurements—proved effective and accessible, even in low-resource environments. He also reflects on presenting at ACC, the importance of early preparation, and the growth that comes from taking on complex international research. Dr. Inoue encourages young clinicians to embrace challenges and actively engage with global networks for clinical research development.

In a rapidly changing world marked by societal divisions, technological advances in healthcare, and shifting views on expertise, the JACC Journals remain dedicated to advancing global cardiovascular health through a science-based and humanistic approach. Committed to evidence, integrity, and humanity, JACC focuses on rigorously evaluating research, guided by facts rather than ideology, and strives to address healthcare inequities while respecting patient autonomy. As a trusted platform, it emphasizes collaboration, innovation, and inclusivity to improve cardiovascular health worldwide. By providing actionable science for clinicians and accessible insights for patients, the JACC Journals aim to lead the way in advancing cardiovascular medicine, fostering trust, and making a lasting impact on global health.