Valvular & structural heart disease
Risk Stratification in Left Bundle Branch Block After Transcatheter Aortic Valve Implantation: A Multicenter Electrocardiogram (ECG) Algorithm Study
Authors' conclusion
The novel, simplified ECG algorithm showed a superior performance for the rule-out and rule-in of infranodal conduction delay compared with current ESC ECG criteria.
Study context
- Population
- Patients with preexisting or new-onset left bundle branch block (LBBB) after transcatheter aortic valve implantation (TAVI) undergoing electrophysiology testing, 7 institutions12% preexisting LBBB
- Participants
- 769 patients
- Comparison
- Novel simplified ECG algorithm vs current European Society of Cardiology (ESC) ECG criteria
- Outcome
- Infranodal conduction delay (His-ventricular interval ≥70 ms)
Methodological detailsmulticentre, prospectively enrolled
- Multicentre
- Prospectively enrolled
Performance
As reported in the abstract
Infranodal conduction delay (HV ≥70 ms)
| Test or model | Sensitivity (rule-out: PR <190 ms AND QRS <160 ms) | Sensitivity | Specificity (rule-in: PR ≥190 ms AND QRS ≥160 ms) | Specificity | PPV (rule-in) | PPV | NPV (rule-out) | NPV |
|---|---|---|---|---|---|---|---|---|
| Novel algorithm | 88% | Not reported in the abstract | 85% | Not reported in the abstract | 41% | Not reported in the abstract | 92% | Not reported in the abstract |
| ESC ECG criteria | Not reported in the abstract | 72% | Not reported in the abstract | 53% | Not reported in the abstract | 28% | Not reported in the abstract | 88% |
Sensitivity (rule-out: PR <190 ms AND QRS <160 ms)
Novel algorithm88%
ESC ECG criteriaNot reported in the abstract
Sensitivity
Novel algorithmNot reported in the abstract
ESC ECG criteria72%
Specificity (rule-in: PR ≥190 ms AND QRS ≥160 ms)
Novel algorithm85%
ESC ECG criteriaNot reported in the abstract
Specificity
Novel algorithmNot reported in the abstract
ESC ECG criteria53%
PPV (rule-in)
Novel algorithm41%
ESC ECG criteriaNot reported in the abstract
PPV
Novel algorithmNot reported in the abstract
ESC ECG criteria28%
NPV (rule-out)
Novel algorithm92%
ESC ECG criteriaNot reported in the abstract
NPV
Novel algorithmNot reported in the abstract
ESC ECG criteria88%
Further findings
Prevalence of HV ≥70 ms
- His-ventricular ≥70 ms
- 21%
Original publication
Risk Stratification in Left Bundle Branch Block After Transcatheter Aortic Valve Implantation: A Multicenter ECG Algorithm Study. JACC Clin Electrophysiol. Published 24 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it