New-Onset Left Bundle Branch Block Induced by Transcutaneous Aortic Valve Implantation

Incidence of arrhythmias and impact of permanent pacemaker implantation in hospitalizations with transcatheter aortic valve replacement

“…Hospitalizations with a preexisting The incidence of new-onset LBBB post-TAVR ranges from 5% to 65% and has resulted in the insertion of a PPM in 15% to 20% of patients in the acute period; however, the incidence of late appearance, from discharge to 1 year, ranges between a mere 0% and 2.9%. [15][16][17][18] In this study, 8.9% of the entire patient cohort developed new-onset LBBB, 13% of whom received a new PPM. Pacemakers are implanted relatively quickly to reduce the possibility of the LBBB evolving into a complete AVB; however, a short waiting period may eliminate the need for a PPM because of possible regression of the LBBB due to acute edema.…”

“…The incidence of new‐onset LBBB post‐TAVR ranges from 5% to 65% and has resulted in the insertion of a PPM in 15% to 20% of patients in the acute period; however, the incidence of late appearance, from discharge to 1 year, ranges between a mere 0% and 2.9% . In this study, 8.9% of the entire patient cohort developed new‐onset LBBB, 13% of whom received a new PPM.…”

“…16 It is suggested that a proximal lesion of the left bundle branch at the immediate exit of the bundle of His is an indicator for LBBB. 16 The close anatomical location of the aortic annulus to the AV nodal-Hisian system may explain why the valve may disrupt the intra-and infra-Hisian conduction system, leading to the development of a new LBBB. The progression of the LBBB into a complete AVB may help explain the association with adverse events.…”

“…In this study, 8.9% of the entire patient cohort developed new‐onset LBBB, 13% of whom received a new PPM. Pacemakers are implanted relatively quickly to reduce the possibility of the LBBB evolving into a complete AVB; however, a short waiting period may eliminate the need for a PPM because of possible regression of the LBBB due to acute edema . It is suggested that a proximal lesion of the left bundle branch at the immediate exit of the bundle of His is an indicator for LBBB .…”

Heart block following transcatheter aortic valve implantation: a matter of right bundle branch integrity?

“…The likelihood of recovery of LBBB after TAVI is a relatively new question in clinical cardiology practice and there have not been many examples of similar conditions from which prior lessons can be applied to this particular question. A recently published review on this subject gathers many relevant studies and examines available data [13]; however, there are many important questions that remain to be answered and therefore it is important to study this subject in the post-TAVI patients while keeping in mind the evolution of TAVI techniques and changes in the TAVI patient population. This may, therefore, limit the applicability of findings of such studies for future TAVI indications.…”