Related Experiment Video
Updated: Apr 12, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Impact of left ventricular conduction defect with or without need for permanent right ventricular pacing on
Marcel Weber1, Eva Brüggemann2, Robert Schueler2
1Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Sigmund-Freud-Str.25, 53105, Bonn, Germany. Marcel.Weber@ukb.uni-bonn.de.
Background:
Left ventricular conduction disturbances (VCD) with or without need for pacemaker (PM) implantation are common after transcatheter aortic valve replacement (TAVR). Its effect on patients' functional recovery after TAVR is unclear.
Methods And Results:
212 patients (Age 80.8 ± 6.4 years, logEuroscore 28.95 ± 17.37 %) underwent TAVR with the self-expanding CoreValve prosthesis and completed 9-month follow-up (FU). After TAVR 125 (59 %) patients were diagnosed with VCD. This group consists of 41 (19 %) patients with a new PM after TAVR, 33 (16 %) patients with PM prior TAVR and markedly increased ventricular stimulation rate, 48 (23 %) patients with new LBBB post-TAVR and three (1 %) patients with LBBB prior TAVR. After FU, the presence of VCD alone was associated with worse recovery of left ventricular ejection fraction (LVEF) (VCD: LVEFbaseline 51.7 ± 18.2 %, LVEFFU 53.9 ± 13.0 %; p = 0.8; noVCD: LVEFbaseline 53.8 ± 12.9 %, LVEFFU 63.4 ± 10.1 %; p < 0.01) but had no impact on functional outcomes after TAVR (p > 0.05). Especially patients with VCD caused by permanent RV pacing showed worse functional outcomes presenting with higher functional NYHA classes (p < 0.05), and higher NT-proBNP levels (p < 0.05). 20.4 % of patients with need for PM after TAVR remained in NYHA class ≥3, as compared to 5 % of patients without PM (VCD but no PM: 4.7 %, p < 0.001; noVCD: 5.3 %, p < 0.001). VCD with or without need for PM had no impact on survival after FU.
Conclusion:
The occurrence of VCD after TAVR is common and associated with unfavorable left ventricular functional recovery. However, only the combination of VCD with permanent right ventricular pacing has adverse impact on heart failure-related symptoms after TAVR.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
09:57Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
Published on: January 20, 2022
Related Concept Videos
Aortic Regurgitation III: Medical Management
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation I: Introduction
Mitral Valve Prolapse II: Assessment and Management
Cardiomyopathy V: Interprofessional Care
Mitral Regurgitation III: Medical Management