title: New-Onset Left Bundle Branch Block Induced by Transcutaneous Aortic Valve Implantation.
abstract: New-onset left bundle branch block (LBBB) is a specific concern of transcutaneous aortic valve implantation (TAVI) given its estimated incidence ranging from 5% to 65%. This high rate of occurrence is dependent on the type of device used (size and shape), implantation methods, and patient co-morbidities. The appearance of an LBBB after TAVI reflects a very proximal lesion of the left bundle branch as it exits the bundle of His. At times transient, its persistence can lead to permanent pacemaker implantation in 15% to 20% of cases, most often for high-degree atrioventricular block. The management of LBBB after TAVI is currently not defined by international societies resulting in individual centers developing their own management strategy. The potential consequences of LBBB are dysrhythmias (atrioventricular block, syncope, and sudden death) and functional (heart failure) complications. Prompt postprocedural recognition and management (permanent pacemaker implantation) of patients prevents the occurrence of potential complications and may constitute the preferred approach in this frail and elderly population despite additional costs and complications of cardiac pacing. Moreover, the expansion of future indications for TAVI necessitates better identification of the predictive factors for the development of LBBB. Indeed, long-term right ventricular pacing may potentially increase the risk of developing heart failure in this population. In conclusion, it is thus imperative to not only develop new aortic prostheses with a less-deleterious impact on the conduction system but also to prescribe appropriate pacing modes in this frail population.
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Massoullié
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.affiliation: VCU Pauley Heart Center, Medical College of Virginia/VCU School of Medicine, Richmond, Virginia.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Ellenbogen
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Géraud
authors.initials: G
authors.lastname: Souteyrand
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Jean
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Combaret
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Vorilhon
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Clerfond
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Farhat
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ritter
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Citron
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Jean-R
authors.initials: JR
authors.lastname: Lusson
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Motreff
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ploux
authors.affiliation: Clermont Université, Université d'Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), Clermont-Ferrand, France; Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France. Electronic address: reschalier@chu-clermontferrand.fr.
authors.forename: Romain
authors.initials: R
authors.lastname: Eschalier
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*