Outcomes after pacemaker implantation in patients with new-onset left bundle-branch block after transcatheter aortic valve replacement

New-onset left bundle branch block (N-LBBB) after transcatheter aortic valve replacement (TAVR) is a challenging clinical dilemma. In our single-center study, 60 out of 172 patients who underwent permanent pacemaker implantation (PPM) after TAVR had N-LBBB (34.9%). At a median follow-up duration of...

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Bibliographic Details
Published in:The American heart journal 2019-12, Vol.218, p.128-132
Main Authors: Megaly, Michael, Gössl, Mario, Sorajja, Paul, Anzia, Lucille E., Henstrom, John, Morley, Pamela, Garberich, Ross, Bradley, Steven M., Tang, Chuen Y., Abdelhadi, Raed H., Pederson, Wesley, Poulose, Anil, Gornick, Charles C., Lesser, John, Garcia, Santiago, Sengupta, Jay
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic valve
Bundle-Branch Block - etiology
Bundle-Branch Block - mortality
Bundle-Branch Block - therapy
Bundling
Calcification
Conduction
Dependence
Electrocardiography
Female
Follow-Up Studies
Humans
Implantation
Male
Mortality
Pacemaker, Artificial - statistics & numerical data
Patients
Postoperative Complications - etiology
Postoperative Complications - mortality
Postoperative Complications - therapy
Prosthesis Implantation - statistics & numerical data
Recovery of Function
Time Factors
Transcatheter Aortic Valve Replacement - adverse effects
Transcatheter Aortic Valve Replacement - statistics & numerical data
Treatment Outcome
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Summary:New-onset left bundle branch block (N-LBBB) after transcatheter aortic valve replacement (TAVR) is a challenging clinical dilemma. In our single-center study, 60 out of 172 patients who underwent permanent pacemaker implantation (PPM) after TAVR had N-LBBB (34.9%). At a median follow-up duration of 357 days (IQR, 178; 560 days), two patients (3.5%) were completely pacemaker-dependent, and four others (7%) were partially dependent. Twelve patients (24%) recovered conduction in their left bundle at a median follow-up duration of 5 weeks (IQR, 4; 14 weeks). Due to the lack of clinical predictors of pacemaker dependency, active surveillance is warranted and may be an alternative to permanent pacemaker implantation. [Display omitted]
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2019.07.006