ArticleStructural heart : the journal of the Heart Team2026
Pacemaker Implantation in Patients With Pre-Existing Bundle Branch Block Undergoing Balloon-Expandable Transcatheter Aortic Valve Replacement.
Article in Structural heart : the journal of the Heart Team, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The primary objective of this study was to compare permanent pacemaker (PPM) implantation rates following balloon-expandable transcatheter aortic valve replacement (TAVR) between patients with pre-existing right bundle branch block (RBBB) versus left bundle branch block (LBBB). Secondary objectives were to assess long-term clinical outcomes according to baseline conduction status and post-TAVR PPM implantation and identify independent predictors of PPM implantation. Methods: This retrospective study included 380 patients with pre-existing RBBB (n = 269) and LBBB (n = 111) who underwent balloon-expandable TAVR between 2016 and 2020, excluding those with prior pacemakers or implantable cardioverter defibrillators. Results: Within 30 days following TAVR, PPM implantation was significantly more frequent in patients with preexisting RBBB compared with LBBB (18.59 vs. 7.21%, Conclusions: Patients with preexisting RBBB undergoing balloon-expandable TAVR had a significantly higher and earlier rate of PPM implantation compared to LBBB patients, with no differences in outcomes irrespective of BBB and PPM implantation status. Atrial fibrillation/flutter and RBBB were associated with an increased risk of 30-day PPM implantation, although the risk is acceptable with higher valve implantation.
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