Introduction Atrio-ventricular (AV) conduction abnormalities and subsequent permanent pacemaker (PPM) implantation frequently complicate Transcatheter Aortic Valve Replacement(TAVR). Current guidelines are still unclear in certain clinical scenarios. Methods and Results A 78 year-old with pre-existing Left Bundle Branch Block and 1 ^st degree AV block underwent TAVR complicated by transient complete heart block with no further prolongation of preexisting conduction. Electrophysiology study (otherwise not indicated based on guidelines), 3 days post-procedure revealed evidence of significant infra Hisian disease requiring PPM. Conclusion No specific guidelines are available at this stage and thus our report highlights need for further research into this patient subset.