The Nagging Problem of Conduction Abnormalities After TAVR- ClinicalKey Transcatheter aortic valve replacement (TAVR) is a transformative procedure that has experienced explosive growth since its clinical introduction in 2011. The majority of patients with aortic stenosis are now able to be percutaneously treated in a safe and effective manner, rather than with open heart surgery. Technology and operator experience have significantly evolved in the short time this procedure has been available. Early generation devices were associated with numerous complications. These included vascular injury (both bleeding and ischemic complications) and paravalvular aortic regurgitation. The reduction in vascular injury has been attributed to smaller access size (<16 French) and better knowledge of minimal vessel size requirements and what constitutes adverse vessel characteristics. The reduction in paravalvular aortic regurgitation has been attributed to precise sizing of the aortic annulus with TAVR-protocol computed tomography and improvements in valve design (outer sealing skirt on the Sapien 3 valve [Edwards Lifesciences] and outer pericardial wrap on the Evolut Pro [Medtronic]). Stroke has decreased in frequency to the point that a strategy of routine cerebral embolic protection devices no longer seems warranted. Serious complications, such as coronary occlusion, annular rupture, valve embolization, and conversion to open surgery, are also exceedingly rare.