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Updated: Jun 26, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Long-Term Outcomes After Transcatheter Aortic Valve Replacement Complicated by New-Onset Persistent Left Bundle
Carmen Hodel1, Federico Moccetti1, Stephanie Brunner1
1Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland.
Background:
Long-term data on the relevance of new-onset persistent left bundle branch block (pLBBB) after transcatheter aortic valve replacement (TAVR) are sparse. This study aimed to assess the impact of pLBBB that occurs after TAVR on mortality, hospitalisation for heart failure, new permanent pacemaker (PPM) implantation, and left ventricular ejection fraction (LV-EF).
Aims:
To investigate the impact of pLBBB on long-term outcomes after TAVR.
Methods:
After exclusion of patients with baseline conduction disorders, a pre-existing PPM, valve-in-valve treatment, or in-hospital mortality, a total of 551 patients were analysed. Patients were divided into two groups (pLBBB and no/transient LBBB) and followed over 5 years.
Results:
A pLBBB occurred in 85 patients (15%). Patients with pLBBB had a significantly deeper valve implantation (4.0 ± 1.8 mm vs. 3.3 ± 1.8 mm, p < 0.01). pLBBB was associated with an increased risk for hospitalisation for heart failure (HRadjusted 1.34, 95% CI 1.01-1.76, p = 0.04), whereas all-cause mortality was not elevated. The presence of pLBBB was linked to a significant decline in LV-EF over the follow-up period (58% ± 11% to 55% ± 12%, p = 0.03). There was a trend toward more new PPM implantation but no significant difference (HRadjusted 1.45, 95% CI 0.96-2.18, p = 0.07). A transient LBBB did not affect the studied outcomes.
Conclusions:
During long-term follow-up, patients with a pLBBB were more often hospitalised for heart failure, and experienced a significant reduction in LV-EF in comparison to patients with no or only transient LBBB.
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