Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep;39(9):544-50.
doi: 10.1002/clc.22567. Epub 2016 Jul 19.

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

Tomo Ando  1 , Hisato Takagi  2 ; ALICE (All-Literature Investigation of Cardiovascular Evidence) Group
Affiliations
Review

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

Tomo Ando et al. Clin Cardiol. 2016 Sep.

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, I(2) = 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram for study selection.
Figure 2
Figure 2
Forest plot for midterm (≥1‐year) all‐cause mortality in the NOP‐LBBB and non–NOP‐LBBB groups. Abbreviations: CI, confidence interval; NOP‐LBBB, new‐onset persistent left bundle branch block.
Figure 3
Figure 3
Forest plots for (A) perioperative mortality and (B) midterm cardiovascular mortality in the NOP‐LBBB and non–NOP‐LBBB groups. Abbreviations: CI, confidence interval; NOP‐LBBB, new‐onset persistent left bundle branch block.
Figure 4
Figure 4
Forest plot for repeat hospitalization during midterm follow‐up in the NOP‐LBBB and non–NOP‐LBBB groups. Abbreviations: CI, confidence interval; NOP‐LBBB, new‐onset persistent left bundle branch block.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mack MJ, Leon MB, Smith CR, et al; PARTNER 1 Trial Investigators . 5‐Year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015;385:2477–2484. - PubMed
    1. Barbanti M, Petronio AS, Ettori F, et al. 5‐Year outcomes after transcatheter aortic valve implantation with CoreValve prosthesis. JACC Cardiovasc Interv. 2015;8:1084–1091. - PubMed
    1. Nazif TM, Williams MR, Hahn RT, et al. Clinical implications of new‐onset left bundle branch block after transcatheter aortic valve replacement: analysis of the PARTNER experience. Eur Heart J. 2014;35:1599–1607. - PubMed
    1. Carrabba N, Valenti R, Migliorini A, et al. Impact on left ventricular function and remodeling and on 1‐year outcome in patients with left bundle branch block after transcatheter aortic valve implantation. Am J Cardiol. 2015;116:125–131. - PubMed
    1. Askenazi J, Alexander JH, Koenigsberg DI, et al. Alteration of left ventricular performance by left bundle branch block simulated with atrioventricular sequential pacing. Am J Cardiol. 1984;53:99–104. - PubMed

MeSH terms

LinkOut - more resources