Suicide left ventricle triggered by accelerated junctional rhythm after transcatheter aortic valve implantation: a case report of rhythm-dependent dynamic left ventricular outflow tract obstruction

This case reports AJR as a novel trigger for suicide LV after TAVI, leading to preload reduction and promoting SAM, LVOTO, and MR. Intraoperative TOE provided clear rhythm-dependent imaging of LVOT dynamics. Vigilant rhythm monitoring and prompt, targeted haemodynamic management, including pacing to induce ventricular dyssynchrony, are crucial for prevention and treatment in predisposed patients with small, hypertrophied ventricles with a sigmoid septum.