New-Onset Left Bundle Branch Block After TAVI: An Updated Review
Key result
New-onset LBBB remains the most common complication after TAVI for severe aortic stenosis.
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Why the study?
Although complication rates after TAVI have decreased, new-onset LBBB remains frequent and is the most common complication of the procedure.
Key Points
- To evaluate the causes, incidence, clinical outcomes, and management strategies for new-onset left bundle branch block following TAVI.
- Reviewed literature on new-onset left bundle branch block after TAVI
- Analyzed causes and incidence rates
- Discussed clinical outcomes and management strategies
- New-onset left bundle branch block is the most common complication post-TAVI
- The incidence rates of LBBB remain significant despite improved techniques
- Management strategies can vary and influence clinical outcomes.
Structured PICO
P
Population
Patients with symptomatic severe aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI)
I
Intervention
Transcatheter aortic valve implantation (TAVI)
O
Outcome
New-onset left bundle branch block (LBBB)safety
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“It's long been recognized that conduction disturbances, especially heart block and new left bundle branch block, are the most frequent complication of TAVR, and increasingly there's been evidence that left bundle branch block, in particular, is associated with adverse late clinical outcomes. However, most of that evidence comes from much smaller data sets. The TVT Registry is unique in that it gives us a much larger real-world sample where we can investigate that.”
“Are we going to be able to decrease these incidents below 10%? I'm not sure. Sometimes even if you implant the valve in a very high position, you will still have this conduction problem. But in any case, it is reassuring.”
NSNickpreet SinghCardiologist, NewYork-Presbyterian/Weill Cornell Medical Center
“The mortality curves for patients with versus without LBBB seemed to diverge over the entire 1-year time period. So it's not like these patients are suddenly developing acute heart block after their hospitalization and all the deaths are related to that.”
Implication
New-onset LBBB remains the most frequent complication following TAVI, necessitating ongoing attention to its causes, outcomes, and management.
Abstract
Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for patients with symptomatic severe aortic valve stenosis. Newer-generation devices, increased operator experience, and improved patient selection have contributed to a reduction in complication rates. However, the occurrence of new-onset left bundle branch block (LBBB) after TAVI remains high, and currently it is the most common complication associated with the procedure. This review discusses the current understanding of new-onset LBBB, including its causes, incidence, clinical outcomes, and management strategies.
Discussion
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Cite This Study
Mayol et al. (2026) conducted a review in Severe aortic valve stenosis. Transcatheter aortic valve implantation (TAVI) was evaluated. New-onset left bundle branch block remains the most common complication after transcatheter aortic valve implantation for severe aortic stenosis.