Early Reversal of Cardiac Remodelling in Patients with New-onset Persistent Left Bundle Branch Block after Transcatheter Aortic Valve Replacement

OBJECTIVE New-onset persistent left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR) is an independent predictor of long-term cardiovascular mortality in patients. The aim of this study is to evaluate the impact of new-onset LBBB on early cardiac reverse remodelling and clinical outcomes after TAVR. METHODS A retrospective analysis was performed on 101 patients who underwent successful TAVR for severe aortic stenosis between March 2021 and October 2024 at our institution. Echocardiographic variables indicative of cardiac remodelling were analysed preoperatively and at one and six months after TAVR. Furthermore, the clinical outcomes of the patients were monitored during the follow-up period. RESULT Of the 101 patients who underwent TAVR, 28 (27.7%) had new-onset LBBB. Prosthetic valve implantation depth and serum low-density lipoprotein cholesterol levels were influential factors of new LBBB, which was more prevalent in patients with thinner interventricular septal thickness preoperatively. At the six-month follow-up, new-LBBB group showed an increase in left ventricular diameter and left ventricular mass index and a reduction in left ventricular ejection fraction compared with the preoperative period. Mitral regurgitation in no-LBBB group was significantly reduced at 1 month postoperatively and remained stable by six months. In contrast, mitral regurgitation in new-LBBB group was reduced at one month postoperatively, but worsened at six months.There was no significant difference in rehospitalization within 6 months postoperatively between patients with or without LBBB. CONCLUSIONS New-onset persistent LBBB after TAVR did not affect short-term rehospitalization, but may adversely affect early postoperative reversal of cardiac remodelling.