The incidence of new-onset cardiac conduction disturbances following transcatheter aortic valve implantation (TAVI) has not decreased compared to other complications, and nowadays is by far the most frequent drawback following the procedure. Meanwhile, the global management of TAVI recipients has led to a minimalist approach with short postprocedural length of stay, which may be limited by the occurrence of late arrhythmic events in patients at high-risk. This review focuses on those strategies to overcome the conundrum between early discharge and new-onset conduction disturbances in elderly TAVI candidates and provides a perspective on future improvements in this field.

Transcatheter patent foramen ovale (PFO) closure is a safe and effective treatment for secondary prevention after a PFO-associated stroke as demonstrated in multiple large randomized clinical trials. However, these trials excluded a significant proportion of patients who could have benefited from percutaneous PFO closure due to coexisting potential confounders such as additional thromboembolic risk factors, namely thrombophilia. Since scarce and conflicting data existed on such patients, current clinical management guidelines on patients with PFO mainly recommended against PFO closure in patients with thrombophilia and failed to provide any recommendation on the type and duration of antithrombotic treatment after transcatheter PFO closure. In the past 2 years, there has been new evidence supporting transcatheter PFO closure as a clinically meaningful alternative (vs. medical treatment) in this high-risk group of patients, along with additional data supporting the important role of systematic screening for thrombophilia in PFO-associated cerebrovascular events. This review article provides an updated overview of the incidence, clinical characteristics and outcomes of PFO closure in patients with thrombophilia, also commenting on the most appropriate medical treatment after PFO closure and future perspectives in the field.