Management of Patients With New Left Bundle Branch Block After Transcatheter Aortic Valve Implantation

Summary

The purpose of this study is to show that Electrocardiogram Ambulatory Monitoring-guided strategy is superior to ElectroPhysiological Study on the rate of alive patients with an appropriate Pacemaker implantation/non-implantation, at 12 months after randomization, in patients with New Onset Persistent Left Bundle Branch Block after Transcatheter Aortic Valve Implantation.

Eligibility

Inclusion Criteria:

Patients who are 18 years or older and undergo Transcatheter Aortic Valve Implantation :

1. Presenting with New Onset Persistent Left Bundle Branch Block, defined as a new Left Bundle Branch Block \>150 ms that persists at least two days after Transcatheter Aortic Valve Implantation and is stable
2. With an anticipated life expectancy \>1 year
3. Who consent to participate to the study

Exclusion Criteria:

1. During in-hospital Electrocardiogram monitoring period, immediately after Transcatheter Aortic Valve Implantation and before inclusion:

   * Documented high grade Atrio Ventricular block (Atrio Ventricular block of a degree higher than Mobitz I)
   * Persistent PR interval prolongation \> 240 ms
   * Occurrence of syncope or sudden cardiac death,
   * Identification of any indisputable criteria for Pacemaker implantation
   * Definitive Pacemaker implantation
2. Prior Pacemaker or Implantable Cardiac defibrillator
3. Indication for Cardiac Resynchronization Therapy or Implantable cardiac defibrillator
4. Pre-existing Left Bundle Branch Block or Right Bundle Branch Block
5. Pre-existing PR interval prolongation \> 240 ms
6. Severe or moderate dementia, evaluated before Transcatheter Aortic Valve Implantation, defined as a Mini Mental State Examination \< 15
7. Pregnancy or breastfeeding patient
8. No affiliation to a social security scheme
9. Adult under legal protection (trusteeship, guardianship).

Conditions2

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