Concurrent transcatheter aortic valve replacement and leadless pacemaker implantation in a patient with aortic stenosis and tachycardia-bradycardia syndrome

We present a patient with symptomatic severe aortic stenosis and atrial fibrillation complicated by tachycardia-bradycardia syndrome, deemed too high-risk for surgical valve replacement and referred for transcatheter aortic valve replacement. We show that concurrent implantation of a leadless pacemaker system can be performed successfully with minimal additional risk to the patient, and also, that it can be used to rapidly pace the ventricles to assist in balloon valvuloplasty and prosthetic aortic valve deployment.