Left bundle branch block (LBBB) is the most common conduction abnormality following transcatheter aortic valve replacement (TAVR) and has been associated with adverse clinical outcomes. While multiple predictors of post-TAVR LBBB have been proposed, data remain limited. This systematic review and meta-analysis aims to identify and summarize predictors of new-onset LBBB post-TAVR. A systematic literature search was performed to identify studies that reported predictors of new-onset post-TAVR LBBB. Extracted data included patient factors, electrocardiographic (ECG) and anatomic parameters, and device-related factors. A random-effects model was used to calculate crude risk ratios (RRs), mean differences, and 95% confidence intervals (CI) of the predictors. Of 450 articles screened, 17 studies comprising a total of 6357 patients were included. Among these, 26.4% developed post-TAVR LBBB. Increased risk was associated with diabetes mellitus (RR: 1.22, p < 0.001), use of 29-mm valve (RR: 1.59, p < 0.001), and use of Medtronic CoreValve (MCV) (RR: 2.25, p = 0.008). Significant differences were found between patients with and without LBBB in interventricular septal thickness (IVS; by -0.66 mm), membranous septal length (MSL; by -0.9 mm), left ventricular outflow tract (LVOT) diameter (by -0.48 mm), PR interval (by +13.95 ms), and prosthesis implantation depth (by +2.6 mm). Diabetes Mellitus, use of 29-mm valve or MCV, decreased IVS thickness, shorter MSL, smaller LVOT diameter, increased prosthesis implantation depth, and prolonged PR duration were all associated with an elevated risk of post-TAVR LBBB. Early identification of these predictors may help reduce the risk of conduction abnormalities after TAVR.
Keywords: TAVR; meta‐analysis; new‐onset LBBB; predictors; systematic review; transcatheter aortic valve replacement.
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