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Challenges in Clinical Electrocardiography
May 28, 2021

Beat-to-Beat Variation in QRS Morphology Following Transcatheter Aortic Valve Replacement

Author Affiliations
  • 1Lankenau Medical Center, Wynnewood, Pennsylvania
  • 2Fuwai Huazhong Hospital, Zhengzhou, Henan, China
  • 3Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Intern Med. 2021;181(7):990-991. doi:10.1001/jamainternmed.2021.1997

A man in his 70s with severe symptomatic aortic stenosis underwent transcatheter aortic valve replacement (TAVR) with a self-expanding valve. His 12-lead electrocardiograms (ECGs) prior to TAVR revealed atrial fibrillation (AF) with a narrow QRS complex at a ventricular rate of 56 beats per minute (bpm). An ECG obtained 3 days post-TAVR is shown in the Figure, A. The patient was asymptomatic and hemodynamically stable.

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