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September 1, 2026Journal of the American College of CardiologyOpen Access

Predictive Factors and Long-Term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve

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Why the study?

The predictors and clinical consequences of persistent versus transient or absent LBBB following TAVI with a balloon-expandable valve were unknown.

Population

202 consecutive patients undergoing TAVI with a balloon-expandable valve and no baseline conduction disturbances or PPI

Comparison

Persistent LBBB vs transient or absent LBBB

Design

Consecutive cohort study

Follow-up

Median 12 months

Key result

Persistent LBBB following TAVI with a balloon-expandable valve was associated with a higher incidence of complete AV block requiring pacemaker implantation (20.0% vs. 0.7%; p<0.001).

Authors

MUMarina UreñaMMMichael MokÉDÉric Dumont

Discussion

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Overview

Observational study reveals predictors and adverse outcomes of persistent left bundle branch block following balloon-expandable TAVI, highlighting the need for targeted post-procedural surveillance.

Key Points

  • To identify clinical and procedural predictors of persistent new-onset left bundle branch block following transcatheter aortic valve implantation with balloon-expandable valves and evaluate its long-term clinical consequences.
  • Evaluated patients undergoing transcatheter aortic valve implantation (TAVI) using balloon-expandable valve prostheses.
  • Tracked pre-procedural, intra-procedural, and post-procedural electrocardiographic and clinical parameters to identify persistent left bundle branch block (LBBB).
  • Assessed long-term clinical outcomes, including heart failure hospitalizations, pacemaker requirements, and mortality.
  • Identified specific anatomical and procedural characteristics associated with an increased likelihood of developing persistent LBBB after balloon-expandable TAVI.
  • Persistent post-procedural LBBB correlated with increased rates of adverse cardiac events, repeat hospitalizations, and subsequent permanent pacemaker implantation during long-term follow-up.

Study Design

Type

Cohort (n=202)

PICO

P
Population
202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation undergoing TAVI with a balloon-expandable valve, followed for a median of 12 months.
E
Exposure / Comparator
Persistent left bundle branch block (LBBB) vs Transient or absent LBBB
O
Primary Outcome
Complete atrioventricular block (AVB) requiring permanent pacemaker implantation (PPI), p=<0.001

Main Result

Absolute Event Rate: 20% vs 0.7%

p-value: p=<0.001

Cite This Study

Ureña et al. (2012) conducted a cohort in Patients undergoing transcatheter aortic valve implantation (TAVI) (n=202). Persistent left bundle branch block (LBBB) vs. Transient or absent LBBB was evaluated on Complete atrioventricular block (AVB) requiring permanent pacemaker implantation (PPI) (p=<0.001). Persistent LBBB following TAVI with a balloon-expandable valve was associated with a higher incidence of complete AV block requiring pacemaker implantation (20.0% vs. 0.7%; p<0.001).

synapsesocial.com/papers/6a96b9bfca27f3f914e40f71https://doi.org/10.1016/j.jacc.2012.07.035
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