Iatrogenic Atrioventricular Block

Cardiol Clin. 2023 Aug;41(3):419-428. doi: 10.1016/j.ccl.2023.03.009.


Iatrogenic atrioventricular (AV) block can occur in the context of cardiac surgery, percutaneous transcatheter, or electrophysiologic procedures. In cardiac surgery, patients undergoing aortic and/or mitral valve surgery are at the highest risk for developing perioperative AV block requiring permanent pacemaker implantation. Similarly, patients undergoing transcatheter aortic valve replacement are also at increased risk for developing AV block. Electrophysiologic procedures, including catheter ablation of AV nodal re-entrant tachycardia, septal accessory pathways, para-Hisian atrial tachycardia, or premature ventricular complexes, are also associated with risk of AV conduction system injury. In this article, we summarize the common causes for iatrogenic AV block, predictors for AV block, and general management considerations.

Keywords: Atrioventricular block; Cardiac surgery; Catheter ablation; Complete heart block; Iatrogenic; Transcatheter valve.

Publication types

  • Review

MeSH terms

  • Atrioventricular Block* / etiology
  • Atrioventricular Block* / therapy
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / methods
  • Heart Conduction System
  • Humans
  • Iatrogenic Disease
  • Tachycardia, Atrioventricular Nodal Reentry* / complications
  • Tachycardia, Atrioventricular Nodal Reentry* / surgery
  • Transcatheter Aortic Valve Replacement* / adverse effects