Artificial intelligence and transcatheter aortic valve implantation-induced conduction disturbances-adding insight beyond the human 'I'

Mrs. Smith, an active 83-year-old female with a medical history encompassing hypertension and type 2 diabetes mellitus, presents with symptomatic severe aortic valve stenosis. Her left ventricular function is normal, and there is no evidence of obstructive coronary artery disease. She undergoes a transcatheter aortic valve implantation (TAVI) with a 34 mm self-expandable prosthesis. According to the interventional cardiologist, the procedure was uncomplicated, thereby considering the post-operative left bundle branch block (LBBB) as trivial. As a 5-day post-operative continuous rhythm monitoring reveals no other conduction abnormality or delay, Mrs. Smith is discharged home with a persistent LBBB. However, 2 weeks later, she is re-admitted due to a cardiac syncope attributed to high-grade atrioventricular block (HAVB), necessitating permanent pacemaker implantation (PPMI).