Clinical Impact of Persistent Left Bundle Branch Block After CoreValve Revalving System Implantation. Insight from a Multicenter Italian Registry.

Conduction disturbances are relatively common after Transcatheter Aortic Valve Implantation (TAVI). Previous data demonstrated an adverse impact of persistent left bundle branch block (LBBB) after surgical aortic valve replacement. It is unclear whether a new onset LBBB may also impact on prognosis of patients after TAVI. Among 1060 patients treated with CRS-TAVI between October 2007 and April 2011 in high volume centers in Italy, we considered those without LBBB nor Pace-Maker at admission (879 patients, 82.7%). Those who had received a PM within 48 hours from the procedure were then excluded (61 patients, 7%), resulting in a final study population of 818 patients. Among them, 224 patients (Group A, 27.3%) developed a persistent LBBB, the remaining 594 patients (Group B, 72.7%) did not. Clinical characteristics were similar between groups.In group A, a low implant was significantly more frequent (15% vs 9.8%, p=0.02).At 30 days as well as at 1 year(mean follow up of 266±248 days, median 180 days), survival analyses and inherent log rank tests showed that LBBB was not associated with a higher all-cause mortality, cardiac mortality, hospitalization for heart failure. At 30 days, but not at 1 year, Group A had a significantly higher rate of PM implantation. In this high volume centers registry, persistent LBBB post CRS-TAVI showed no effect on hard end points. On the other hand, LBBB was associated with a higher short term rate of PM implantation