Episode # 41 • 30 Jun 2026
Exploring LV Pacing in TAVR Procedures
Is it time to move beyond RV pacing and rethink the future of TAVR procedures with dedicated LV pacing strategies? In this episode of BackTable Cardiology, host Stephanie Younes talks with Dr. Jeff Southard, interventional cardiologist at UC Davis, about the evolution of left ventricular (LV) pacing and its impact on TAVR workflow. They discuss the limitations of earlier off-the-shelf LV pacing methods, the reasons for relying on RV pacing in the past, and how a shift to dedicated LV pacing wires is changing daily practice for both balloon-expandable and self-expanding valves.
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Timestamps
00:00 - Introduction
02:27 - Early LV Pacing Skepticism
06:08 - Backup Strategy and Capture Test
08:02 - Step by Step TAVR Workflow
12:32 - Reasons for Slow Adoption
14:04 - Wire Design and Iterations
15:55 - Sheath Support in Tough Anatomy
16:57 - Avoiding Aortic Scrape Risks
18:08 - Staffing and Table Roles
20:51 - Beyond TAVR Use
21:58 - Device Design and Reliability
24:16 - EZ-TAVI Data Breakdown
27:28 - Algorithms vs. RV Pacing
29:17 - Purpose Built LV Pacing Wrap Up
30:25 - Wrap Up and Credits
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More about this episode
Dr. Southard details how his team’s adoption of a dedicated LV pacing wire improved reliability, reduced the need for venous access, and helped eliminate RV pacing-wire complications. He explains how this approach has saved time, streamlined staffing by moving pacing control to the sterile table, and minimized procedural steps. The conversation covers patient selection, exceptions for those at higher risk of heart block, technical pearls, and recent data from the EZ-TAVI trial. They also highlight the clinical significance of multi-point LV endocardial contact and adaptive algorithms for maintaining capture during TAVR procedures.
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