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Impact of left bundle branch block after transcatheter aortic valve replacement

Frida Sundh1, Martin Ugander1

  • 1Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.

Journal of Electrocardiology
|August 3, 2014
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) is effective, but new persistent left bundle branch block (LBBB) is common. Further research is needed to understand LBBB

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Transcatheter aortic valve replacement (TAVR) for severe aortic stenosis shows excellent outcomes.
  • A significant incidence of new persistent left bundle branch block (LBBB) occurs post-TAVR.
  • The clinical impact of new LBBB after TAVR remains debated due to conflicting study results.

Purpose of the Study:

  • To review and analyze major studies on new LBBB after TAVR.
  • To identify factors contributing to divergent results across studies.
  • To guide future research on LBBB post-TAVR.

Main Methods:

  • Systematic review of four major studies investigating new LBBB following TAVR.
  • Comparative analysis of study methodologies and patient populations.
  • Evaluation of LBBB diagnostic criteria and clinical outcomes.

Main Results:

  • Significant heterogeneity exists between studies examining new LBBB post-TAVR.
  • Discrepancies in results may stem from variations in LBBB definition and patient selection.
  • Current data is insufficient to definitively assess the impact of new LBBB.

Conclusions:

  • Future studies must clarify if new LBBB post-TAVR meets strict criteria.
  • Investigate the development of left ventricular dyssynchrony in these patients.
  • Determine eligibility for cardiac resynchronization therapy (CRT) in select LBBB cases.

Keywords:
Cardiac resyncronization therapyLeft bundle branch blockTranscatheter aortic valve replacement

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