2026-04-13T03:56:05Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/129592025-10-24T10:39:12Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Mas-Peiro, Silvia
author
lhermusier, thibault
author
Urena, Marina
author
Vilalta, Victoria
author
Muñoz-Garcia, Antonio
author
Serra Garcia, Vicenç
author
Nombela Franco, Luis
2025-10-24T10:39:12Z
2025-10-24T10:39:12Z
2025-04-14T12:26:39Z2025-04-14T12:26:39Z2025-04
http://hdl.handle.net/11351/12959
Conduction disturbances; Pacemaker implantation; Transcatheter aortic valve replacementTrastornos de la conducción; Implante de marcapasos; Reemplazo de válvula aórtica transcatéterTrastorns de la conducció; Implant de marcapassos; Substitució de la vàlvula aòrtica transcatèterAims
Arrhythmic burden after discharge in patients with new-onset persistent left bundle branch block (NOP-LBBB) following transcatheter aortic valve replacement (TAVR) with Evolut devices remains largely unknown. The aim of this study is to assess the incidence and type of arrhythmias at 2-year follow-up in patients with NOP-LBBB post-TAVR.
Methods and results
This is a prospective multicentre study including 88 patients with LBBB persisting for ≥3 days post-implantation. Before discharge, an implantable loop recorder (REVEAL XT/LINQ) was implanted; patients had continuous monitoring for 2 years. Arrhythmic events were adjudicated in a central core lab. Of the arrhythmic events, 411 were detected in 58 patients [65.9%; 2 (1–4) events per patient]. Symptoms were reported in 12/58 (20.7%), and therapy was changed in 25/58 (43.1%). There were 101 bradyarrhythmic events in 33 patients [35 high-grade atrioventricular block (HAVB) and 66 severe bradycardia]. The HAVB incidence was higher in the early (4-week) phase and remained stable over time, whereas severe bradycardia increased after 1 year. Permanent pacemaker was required in 11 (12.5%) patients (6.8% and 5.7% in the first and second year, respectively). There were 310 tachyarrhythmic events in 29 patients (120 AF/AFL, 111 AT, 72 SVT, 6 NSVT, and 1 VT); its incidence decreased throughout the 2 years. New AF/AFL episodes occurred in 20/69 patients [29%; symptomatic in 2/20 (10%)].
Conclusion
Patients with NOP-LBBB post-TAVR with Evolut devices exhibited a high burden of late arrhythmias, with events occurring in two-thirds of patients and leading to treatment changes in about half of them. These data should inform future studies on cardiac monitoring devices for follow-up and treatment optimization in this challenging population.S.M.-P. has received a research grant from the ‘Fundación Alfonso Martín Escudero’ (Madrid, Spain). J.R.-C. holds the Research Chair in ‘Fondation Famille Jaques Larivière’ for the Development of Structural Heart Interventions.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Avaluació de resultats (Assistència sanitària)
Arrítmia - Diagnòstic
Vàlvula aòrtica - Estenosi - Cirurgia - Complicacions
Pròtesis valvulars cardíaques
DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac
Other subheadings::Other subheadings::/diagnosis
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Surgical Procedures, Operative::Prosthesis Implantation::Heart Valve Prosthesis Implantation::Surgical Procedures, Operative::Transcatheter Aortic Valve Replacement
Other subheadings::Other subheadings::Other subheadings::/adverse effects
DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Heart Block::Bundle-Branch Block
Other subheadings::Other subheadings::/diagnosis
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome
ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas
Otros calificadores::Otros calificadores::/diagnóstico
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::intervenciones quirúrgicas::implantación de prótesis::implantación de prótesis valvulares cardíacas::intervenciones quirúrgicas::sustitución valvular aórtica con catéter
Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos
ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::bloqueo cardíaco::bloqueo de rama
Otros calificadores::Otros calificadores::/diagnóstico
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Late arrhythmic burden in patients with left bundle branch block after TAVR with the Evolut valve
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion