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Predictors of Post-TAVR Left Bundle Branch Block: A Systematic Review and Meta-Analysis

Hossam Alzu'bi1, Anan Abu Rmilah2,3, Hisham F Bahmad4

  • 1Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, USA.

Journal of Cardiovascular Electrophysiology
|July 7, 2025
PubMed

Insights

Predictors of new left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) were identified. Diabetes, specific valve sizes/types, and anatomical factors increase LBBB risk, aiding early intervention.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Left bundle branch block (LBBB) is a common complication after transcatheter aortic valve replacement (TAVR).
  • Post-TAVR LBBB is linked to adverse clinical outcomes.
  • Predictors for LBBB post-TAVR require further elucidation.

Purpose of the Study:

  • To systematically review and meta-analyze predictors of new-onset LBBB following TAVR.
  • To identify patient, electrocardiographic, anatomic, and device-related factors associated with post-TAVR LBBB.

Main Methods:

  • Systematic literature search of studies reporting post-TAVR LBBB predictors.
  • Meta-analysis using a random-effects model to calculate risk ratios and mean differences.
  • Inclusion of 17 studies with 6357 patients.

Main Results:

  • 26.4% of patients developed post-TAVR LBBB.
  • Predictors of increased LBBB risk include diabetes mellitus, use of 29-mm valves, and Medtronic CoreValve (MCV).
  • Significant differences observed in interventricular septal thickness, membranous septal length, LVOT diameter, PR interval, and implantation depth.

Conclusions:

  • Diabetes, specific valve characteristics (29-mm, MCV), decreased septal thickness, shorter septal length, smaller LVOT diameter, deeper implantation, and prolonged PR interval are associated with higher LBBB risk.
  • Early identification of these predictors can potentially mitigate conduction abnormalities post-TAVR.

Keywords:
TAVRmeta‐analysisnew‐onset LBBBpredictorssystematic reviewtranscatheter aortic valve replacement

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