The evaluation of rhythm disturbances after transcatheter aortic valve replacement (TAVR) has been somewhat of a moving target. Indications for a pacemaker in patients absolutely requiring a permanent implant (PPI), such as those with new complete atrioventricular block (AVB), are usually quite clear. However, avoidance of PPI in patients who may not need one can be challenging. In this issue of CRM , Skaf et al. report “Rhythm Disturbances After Transcatheter Aortic Valve Replacement: A Strategy of Surveillance.” This single-center, prospective, observational study examines conduction disturbances after TAVR. Patients with new AVB, new left bundle branch block (LBBB) or right bundle branch block (RBBB) were followed with telemetry for 48 hours.