Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Rethinking pacing strategy after TAVI: LBBAP vs. RV pacing
Session:
Sessão de Posters 19 - Temas quentes em pacing e eletrofisiologia na era atual
Speaker:
Ana L. Silva
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.4 Syncope and Bradycardia - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Ana L. Silva; Tatiana Pereira dos Santos; Mariana Rodrigues Simões; Maria João Primo; Ana Luísa Rocha; Inês Cruz; Didier Martinez; Patrícia Alves; Carolina Saleiro; João André Ferreira; Natália António; Lino Gonçalves
Abstract
<p style="text-align:justify"><strong>Background: </strong>Conduction system injury remains one of the most frequent complications following transcatheter aortic valve implantation (TAVI), often requiring permanent pacemaker implantation. While left bundle branch area pacing (LBBAP) has shown physiologically favorable results in other populations, evidence in TAVI patients is still limited.</p> <p style="text-align:justify"><strong>Purpose: </strong>To compare electrical and clinical outcomes between right ventricular pacing (RVP) and LBBAP in patients undergoing pacemaker implantation following TAVI.</p> <p style="text-align:justify"><strong>Methods: </strong>This single-center, retrospective study included consecutive TAVI patients who received either RVP or LBBAP between September 2022 and July 2024. Confirmed LBB capture was defined by QRS transition with output reduction (from non-selective to left ventricular septal pacing or to selective LBB capture), paced V6 RWPT<75 ms (<80 ms in LBBB), V6–V1 interpeak interval >44 ms, or selective capture on programmed stimulation. The primary outcome was a composite of heart failure (HF) emergency department admissions or HF hospitalizations.</p> <p style="text-align:justify"><strong>Results: </strong>A total of 84 patients were included: 52 (61.9%) received RVP and 32 (38.1%) LBBAP. Mean age was 81.7±5.0 years, 66.7% were male, and median follow-up was 30.7 months. Baseline characteristics were similar between groups. Third-degree atrioventricular block was the most frequent indication (71.4%), and 75.0% were in sinus rhythm.<br /> Paced QRS duration was significantly shorter with LBBAP (116.0, IQR 16.0 vs 152.0, IQR 33.0ms; p<0.001). QRS variation differed significantly between groups, with RVP resulting in QRS prolongation (+16.5±31.7ms) and LBBAP producing QRS shortening (-33.8±22.9ms; p<0.001). In the LBBAP group, paced LVAT was 75.5ms (IQR 17.0), and the V6–V1 R-wave interpeak interval was 38.0ms (IQR 44.0). Pacing thresholds were similar (p=0.073), although sensing amplitudes were higher with LBBAP (14.5mV, IQR 7.0 vs 10.9mV, IQR 7.2; p=0.017).<br /> Despite lower baseline left ventricular ejection fraction (LVEF) in the LBBAP group (52.0%, IQR 20.0 vs 57.0%, IQR 11.0; p=0.028), LVEF improved significantly with LBBAP (+5.0%, IQR 14.7; p<0.001) but not with RVP (0.0%, IQR 10.3; p=0.592).<br /> The primary composite endpoint occurred in 6.3% of LBBAP patients and 11.5% of RVP patients (p=0.473). After adjustment for age, sex, and pacing percentage, the difference was not statistically significant (HR 3.192; 95% CI 0.530–19.213; p=0.205), although the hazard curves separated early in favor of LBBAP.</p> <p style="text-align:justify"><strong>Conclusion: </strong>Although no statistically significant difference in the primary outcome was identified, LBBAP demonstrated more physiological ventricular activation, improved LVEF, and higher sensing amplitudes than RVP. These findings support the potential clinical benefit of LBBAP in TAVI patients and justify further investigation in larger cohorts.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site