The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

ABSTRACT New‐onset persistent left bundle branch block (NOP‐LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP‐LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP‐LBBB patients after TAVI were included. The random‐effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals. Adjusted HRs were utilized over unadjusted HRs or risk ratios when available. A total of 4049 patients (807 and 3242 patients with and without NOP‐LBBB, respectively) were included. Perioperative (in‐hospital or 30‐day) and midterm all‐cause mortality and midterm cardiovascular mortality were comparable between the groups. The NOP‐LBBB patients experienced a higher rate of permanent pacemaker implantation (HR: 2.09, 95% confidence interval: 1.12‐3.90, P = 0.021, I2 = 83%) during midterm follow‐up. We found that NOP‐LBBB after TAVI resulted in higher permanent pacemaker implantation but did not negatively affect the midterm prognosis. Therefore, careful observation during the follow‐up is required.
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Review Source Type: research