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Conduction Disorders After Transcatheter Aortic Valve Implantation: Evolution Over Time and Association With

Aileen Paula Chua1, Rinchyenkhand Myagmardorj1, Takeru Nabeta1

  • 1Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands.

Structural Heart : the Journal of the Heart Team
|June 18, 2025
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) can cause conduction abnormalities (CA). Patients needing a permanent pacemaker (PPM) after TAVI face higher long-term mortality and impaired left ventricular function.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Transcatheter aortic valve implantation (TAVI) indications are expanding.
  • New conduction abnormalities (CA), such as left bundle branch block (LBBB) or permanent pacemaker (PPM) implantation, are significant TAVI complications.
  • Limited data exist on the long-term outcomes of post-TAVI CA.

Purpose of the Study:

  • To investigate the progression of CA within the first year post-TAVI.
  • To evaluate the long-term prognostic value of these CA.
  • To assess the impact of CA on left ventricular function and all-cause mortality.

Main Methods:

  • Categorized TAVI patients into: PPM implantation within 1 year, persistent LBBB at 1 year (permanent LBBB), or no CA.
  • Assessed all-cause mortality as the primary endpoint.
  • Collected data on baseline characteristics, valve type, left ventricular ejection fraction, global longitudinal strain, and long-term survival.

Main Results:

  • 30% developed new LBBB, 17% had persistent LBBB, and 12% required PPM during hospitalization.
  • At 1 year, PPM and permanent LBBB groups showed reduced left ventricular ejection fraction and global longitudinal strain compared to the no-CA group.
  • Long-term follow-up (median 4 years) revealed higher all-cause mortality in the PPM group (p=0.006).

Conclusions:

  • Post-TAVI CA exhibit dynamic changes within the first year.
  • Patients requiring PPM after TAVI demonstrate poorer long-term outcomes and impaired left ventricular function.
  • PPM implantation and reduced global longitudinal strain are independent predictors of mortality post-TAVI.
Abstract

Keywords:
Conduction disorders post-TAVILeft bundle branch blockLong-term outcomesPermanent pacemaker

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