Closing the Gap: Post-TAVR and TTVR Monitoring as a Clinical and Operational Imperative

DESCRIPTION

More than 134,000 TAVR procedures were performed in the U.S. in 2026, yet a dangerous and largely unaddressed gap persisted at discharge: late conduction disturbances such as heart block, new-onset atrial fibrillation (AF) and progressive conduction failure emerge days to weeks after the procedure, in patients who left the hospital with a normal electrocardiogram. Published data show that 38% of post-TAVR patients who ultimately required pacemaker implantation had no detectable abnormality at discharge, and new-onset AF is captured in approximately one in 10 patients receiving structured outpatient monitoring. Guidelines published in the Journal of the American College of Cardiology identified 20–30% of TAVR patients as candidates for two to four weeks of post-discharge ambulatory monitoring, yet most are not receiving it.

Join Benjamin D'Souza, MD, of the University of Pennsylvania, along with faculty from leading structural heart programs, for a data-driven discussion on which patients need monitoring and why, what the evidence from high-volume centers actually shows, how continuous cellular mobile cardiac telemetry (MCT) captures events that patch and Holter alternatives miss entirely, and how the Independent Diagnostic Testing Racility (IDTF) split-bill reimbursement model (CPT 93228/93229) creates a financially sustainable framework for programs ready to act. Transcatheter tricuspid valve replacement (TTVR), now covered by the Centers for Medicare & Medicaid Services and growing rapidly, will also be addressed.