Cardiac resynchronisation therapy for reversal of new-onset left bundle branch block and heart failure after surgical aortic valve replacement

Mandeep Singh Kalsi; Nalin Dayawansa; Vivek Mutha

doi:10.1136/bcr-2020-238130

Cardiac resynchronisation therapy for reversal of new-onset left bundle branch block and heart failure after surgical aortic valve replacement

BMJ Case Rep. 2020 Dec 10;13(12):e238130. doi: 10.1136/bcr-2020-238130.

Authors

Mandeep Singh Kalsi¹, Nalin Dayawansa², Vivek Mutha²

Affiliations

¹ Department of Cardiology, The Northern Health, Epping, Melbourne, Victoria, Australia kalsi31@gmail.com.
² Department of Cardiology, The Northern Health, Epping, Melbourne, Victoria, Australia.

Abstract

Left bundle branch block (LBBB) is not an uncommon complication following both surgical aortic valve replacement and transcatheter aortic valve implantation. LBBB can cause interventricular and intraventricular dyssynchrony that can lead to development of heart failure as demonstrated by a decline in left ventricular ejection fraction (LVEF). It is known that change in QRS duration has significant correlation with change in LVEF. In a study involving 202 consecutive patients with no baseline ventricular conduction disturbances or previous permanent pacemaker implantation who underwent transcatheter aortic valve replacement (TAVR) with a balloon-expandable valve, it was found that around 30% of patients develop new LBBB.

Keywords: heart failure; interventional cardiology; pacing and electrophysiology.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Bundle-Branch Block / physiopathology
Bundle-Branch Block / therapy*
Cardiac Resynchronization Therapy*
Electrocardiography
Female
Heart Failure / physiopathology
Heart Failure / therapy*
Humans
Stroke Volume
Transcatheter Aortic Valve Replacement / adverse effects*
Treatment Outcome
Ventricular Function, Left