Valvular & structural heart diseaseCohort study
Late arrhythmic burden in patients with left bundle branch block after transcatheter aortic valve replacement (TAVR) with the Evolut valve
- Prospective cohort study
- multicentre
- Arrhythmic events adjudicated in a central core lab
Authors' 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.
Study context
- Population
- Patients with new-onset persistent LBBB (≥3 days) after TAVR with Evolut devices, monitored by implantable loop recorder
- Participants
- 88 patients
- Outcome
- Incidence and type of arrhythmias
- Follow-up
- 2-year follow-up
Main finding
As reported in the abstract
Arrhythmic events (any) · 2 years
- Arrhythmic events detected
- 411
- Patients with arrhythmic events
- 58 (65.9%)
- Events per patient, median (IQR)
- 2 (1-4)
- Symptoms reported
- 12/58 (20.7%)
- Therapy changed
- 25/58 (43.1%)
Observational data: associations, not effects.
Further findings
Bradyarrhythmic events
- Bradyarrhythmic events
- 101 in 33 patients
- High-grade AV block
- 35
- Severe bradycardia
- 66
- HAVB incidence higher in early (4-week) phase, then stable; severe bradycardia increased after 1 year
Permanent pacemaker
- Permanent pacemaker required
- 11 (12.5%)
- First year
- 6.8%
- Second year
- 5.7%
Tachyarrhythmic events
- Tachyarrhythmic events
- 310 in 29 patients
- AF/AFL
- 120
- AT
- 111
- SVT
- 72
- NSVT
- 6
- VT
- 1
- Incidence decreased throughout the 2 years
New AF/AFL
- New AF/AFL episodes
- 20/69 (29%)
- Symptomatic
- 2/20 (10%)
Original publication
Late arrhythmic burden in patients with left bundle branch block after TAVR with the Evolut valve. Europace. Published 19 March 2025. doi:10.1093/europace/euaf057
Summarised from the published abstract; every number is checked against it