Valvular & structural heart disease
Long-term outcomes of left bundle branch area pacing compared with right ventricular pacing in transcatheter aortic valve implantation (TAVI) patients
Authors' conclusion
LBBAP improved long-term clinical outcomes compared with RVP in patients undergoing PPMI after TAVI in terms of less HFH and better LVEF improvement.
Study context
- Population
- Patients requiring new-onset permanent pacemaker implantation after TAVI
- Participants
- 237 patients
- Exposure
- Left bundle branch area pacing (LBBAP) vs right ventricular pacing (RVP) after TAVI
- LBBAPn = 120
- RVPn = 117reference
- Outcome
- Long-term outcomes: all-cause death, HF rehospitalization (HFH), LVEF change from baseline
- Follow-up
- Until 5 years post-TAVI
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
5 years after TAVI
RVP
- All-cause death
- 13.7%
- Death or HFH
- 29.9%
- HFH
- 21.4%
LBBAP
- All-cause death
- 13.3%
- Death or HFH
- 19.2%
- HFH
- 7.5%
All-cause death
RVP13.7%
LBBAP13.3%
Death or HFH
RVP29.9%
LBBAP19.2%
HFH
RVP21.4%
LBBAP7.5%
RVP vs LBBAPAdjusted hazard ratio (95% CI)P value
All-cause death
0.76(0.37–1.58)
P = 0.466Death or HFH
1.22(0.70–2.13)
P = 0.476HFH
2.26(1.01–5.08)
P = 0.048- Greater left ventricular ejection fraction (LVEF) improvement over time with LBBAP
- P = 0.046
Observational data: associations, not effects.
Further findings
Paced QRS duration
P < 0.001
Original publication
Long-term outcomes of left bundle branch area pacing compared with right ventricular pacing in TAVI patients. Heart Rhythm. Published 15 September 2024. doi:10.
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