Arrhythmias & electrophysiology
ECG characteristics of “true” left bundle branch block: Insights from transcatheter aortic valve–related left bundle branch block (LBBB) and His-Purkinje conduction system pacing–correctable LBBB
Authors' conclusion
Strauss criteria and QRS notching are highly prevalent in LBBB after TAVR and in LBBB correctable by CSP.
Study context
- Population
- Patients with LBBB after transcatheter aortic valve replacement (TAVR) or LBBB correctable by conduction system pacing
- Participants
- 181 patients
- Exposure
- Post-TAVR vs conduction system pacing (CSP)-correctable
- Post-TAVRn = 123
- CSP-correctablen = 58
- Outcome
- ECG morphological features of LBBB (QRS duration, notching and slurring in leads I, aVL, V1, V2, V5, V6 and inferior leads)
Methodological details2 centres, consecutive patients
- 2 centres
- Consecutive patients
Main finding
As reported in the abstract
ECG features, combined cohort
Failed to completely meet Strauss criteria
17 of 181
9.4%
Dominant R waves in leads I and aVL
176 of 181
97.2%
q/Q waves in leads I and aVL
21 of 181
11.6%
Notched or slurred QRS in ≥1 of leads I, aVL, V5, V6
181 of 181
100%
Observational data: associations, not effects.
Further findings
Pacing modality in CSP-correctable group
- His-bundle pacing
- 14 (24.1%)
- Left bundle branch area pacing
- 44 (75.9%)
Original publication
ECG characteristics of “true” left bundle branch block: Insights from transcatheter aortic valve–related LBBB and His-Purkinje conduction system pacing–correctable LBBB. Heart Rhythm. Published 9 September 2023. doi:10.
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