Key result
LBBP linked to ~44 ms narrower paced QRS duration versus RVP in post-TAVI patients.
Why the study?
Conduction disturbances after TAVI frequently necessitate permanent pacing, but conventional right ventricular pacing may induce dyssynchrony and heart failure, and evidence on LBBP in this setting remains limited.
Does left bundle branch pacing improve electrical synchrony and maintain stable pacing parameters compared to right ventricular pacing in post-TAVI patients requiring permanent pacing?
Cohort (n=27)
No
Does left bundle branch pacing improve electrical synchrony and maintain stable pacing parameters compared to right ventricular pacing in post-TAVI patients requiring permanent pacing?
Absolute Event Rate: 114% vs 158%
p-value: p=<0.001
Left bundle branch pacing is a feasible and physiologically superior alternative to right ventricular pacing for patients requiring permanent pacemakers after TAVI, resulting in significantly narrower QRS durations and stable short-term electrical performance.
LBBP shows high procedural success post-TAVI without major complications; hypothesis-generating for this population, requiring randomized outcome trials.
Background Conduction disturbances frequently occur after transcatheter aortic valve implantation (TAVI), often necessitating permanent pacing. Conventional right ventricular pacing may induce ventricular dyssynchrony and aggravate heart failure. Left bundle branch pacing (LBBP) has emerged as a physiological alternative, yet evidence regarding its performance and outcomes after TAVI remains limited. Purpose To evaluate the feasibility, procedural characteristics, and short-term outcomes of LBBP in patients requiring permanent pacing after TAVI, using a retrospective single-centre cohort. Methods We retrospectively analysed consecutive post-TAVI patients who underwent permanent pacemaker implantation between January 2023 and May 2025 at a tertiary centre. Patients receiving LBBP were identified and evaluated for procedural success, capture thresholds, R-wave amplitude, paced QRS duration, and short-term complications. Follow-up included 6-month device interrogation and echocardiographic assessment. Statistical comparisons used the Mann–Whitney U and chi-square tests, with p < 0.05 considered significant. Results Among 27 post-TAVI patients requiring pacing, LBBP was attempted in 21 and successfully achieved in 19 (90 %). Mean capture threshold was 0.7 ± 0.2 V @ 0.5 ms, R-wave amplitude 9.1 ± 3.4 mV, and impedance 612 ± 75 Ω. Paced QRS duration was significantly narrower with LBBP compared to right ventricular pacing (114 ± 12 ms vs 158 ± 20 ms, p < 0.001). No major complications were observed. Over a median 6-month follow-up, pacing parameters remained stable, and no deterioration in left-ventricular ejection fraction or heart failure symptoms was noted. Conclusions In this retrospective cohort, LBBP after TAVI demonstrated high procedural success, stable electrical performance, and favourable short-term outcomes. These findings support LBBP as a feasible and physiological pacing modality in post-TAVI patients, warranting larger prospective studies for long-term validation.Baseline and Procedural CharacteristicsComparison of Electrical Parameters
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Quang et al. (2026) conducted a cohort in Post-TAVI patients requiring permanent pacing (n=27). Left bundle branch pacing vs. Right ventricular pacing was evaluated on Paced QRS duration (p=<0.001). Left bundle branch pacing in post-TAVI patients resulted in a significantly narrower paced QRS duration compared to right ventricular pacing (114 vs 158 ms, p<0.001) with 90% procedural success.
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