Pre-existing right bundle branch block (RBBB) in patients undergoing transcatheter aortic valve replacement (TAVR) significantly increases the risk of developing post-procedural conduction disturbances, specifically left bundle branch block (LBBB) and high-degree atrioventricular block (HAVB) . Recent recommendations were outlined by the American College of Cardiology (ACC) to monitor this high-risk group with transvenous pacemaker intra- and immediately post-procedure, when the majority of conduction disturbances are reported to occur . Delayed onset arrhythmias after index hospitalizations have also been reported in up to 30 % of patients, with baseline RBBB patients having up to a 26-fold greater risk . Permanent pacemaker implantation (PPM) for indicated electrical disturbances occurs in a reported 19 % of patients post-TAVR . Risk factors for PPM post-TAVR include baseline conduction disturbances, most notably RBBB; valve type; patient anatomy; and implantation depth . At 2 years post-TAVR, baseline RBBB patients without PPM have been shown to have higher rates of cardiovascular death.