Introduction
Over the past decade, Transcatheter Aortic Valve Replacement (TAVR) has evolved as the standard of care for patients with severe aortic stenosis (AS). With the expansion of its use to patients with low surgical risk the volume of TAVR procedures has increased, as has the rate of associated complications (1). Conduction abnormalities leading to permanent pacemaker implantation (PPMI) is one of the most common (2). These abnormalities are believed to occur due to ischemia, hemorrhage, edema, or trauma either during or after the procedure (3). Even with the advances in both technology and procedural technique, and with the use of newer generation valves, the rate of PPMI following TAVR remains high. However, the rate differs between the two most widely used bioprosthetic valves; the balloon-expandable valve (BEV) and the self-expandable valve (SEV) (4). The clinical impact of PPMI is of significant concern. This is not only due to its high incidence but also to the potentially adverse effects on outcomes and the side effects of long-term right ventricular pacing (5). The aim of our meta-analysis was to systematically review and evaluate the predictors associated with increased risk.