Effects of Left Bundle Branch Block and Pacemaker Implantation on Left Ventricular Systolic Function After Transcatheter Aortic Valve Implantation

Permanent pacemaker implantation (PPI) and left bundle branch block (LBBB) frequency after transcatheter aortic valve implantation (TAVI) and their effect on left ventricular ejection fraction (LVEF) remain controversial. We evaluated the incidence of PPI and new-onset LBBB after TAVI and their impa...

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Bibliographic Details
Published in:The American journal of cardiology 2022-09, Vol.179, p.64-69
Main Authors: Dolci, Giulia, Singh, Gurpreet K., Wang, Xu, van der Kley, Frank, de Weger, Arend, Bootsma, Marianne, Ajmone Marsan, Nina, Bax, Jeroen J., Delgado, Victoria
Format: Article
Language:English
Subjects:
Abnormalities
Aorta
Aortic stenosis
Aortic valve
Cardiology
Conduction
Electrocardiography
Heart
Heart valves
Implantation
Pacemakers
Patients
Prostheses
Recovery
Tomography
Transplants & implants
Ventricle
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Summary:Permanent pacemaker implantation (PPI) and left bundle branch block (LBBB) frequency after transcatheter aortic valve implantation (TAVI) and their effect on left ventricular ejection fraction (LVEF) remain controversial. We evaluated the incidence of PPI and new-onset LBBB after TAVI and their impact on LVEF at 6-month follow-up. Moreover, the impact of right ventricular (RV) pacing burden on changes in LVEF after TAVI was analyzed. The electrocardiograms of 377 patients (age 80 ± 7 years, 52% male) treated with TAVI were collected at baseline, after the procedure, at discharge, and at each outpatient follow-up. LVEF was measured at baseline before TAVI and 6 months after the procedure. Patients were divided into 3 groups according to the occurrence of LBBB, the need for PPI, or the absence of new conduction abnormalities. In patients with PPI, the influence of RV pacing burden on LVEF was analyzed. New-onset LBBB after TAVI occurred in 92 patients (24%), and PPI was required in 55 patients (15%). In patients without new conduction abnormalities, LVEF significantly increased during follow-up (56 ± 14% to 61 ± 12%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2022.06.014