Electrocardiographic features that militate against early hospital discharge after transcatheter aortic valve replacement

An 84-year-old woman was referred for transcatheter aortic valve replacement (TAVR) after severe symptomatic aortic stenosis (valve area, 0.9 cm2; peak and mean transaortic pressure gradients of 63 mm Hg and 32 mm Hg, respectively). She had a medical history of renal cell carcinoma after nephrectomy with a creatinine level of 1.7 mg/L. Echocardiography showed preserved left ventricular function and mild to moderate aortic and mitral regurgitation. Normal coronary arteries were found on coronary angiography before TAVR. The preprocedural electrocardiogram (ECG) displayed sinus rhythm at 65 beats/min without conduction disorders. PR interval was 158 ms; QRS duration, 88 ms; and QRS axis, 42° (Figure 1).