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Peer-reviewedCC BY-NC-NDStructural Heart

Temporary Active Fixation Leads in Transcatheter Aortic Valve Replacement Patients With Baseline Right Bundle Branch Block

  • Quentin Fischer, MD1
  • Marina Urena, MD, PhD2
  • Lluis Asmarats, MD, PhD3
  • Gabriela Veiga Fernandez, MD, PhD4
  • Victoria Vilalta, MD, PhD5
  • Luis Nombela-Franco, MD, PhD6
  • Guillem Muntané-Carol, MD, PhD7
  • Ander Regueiro, MD, PhD8
  • François Philippon, MD1
  • Josep Rodés-Cabau, MD, PhD9
9 affiliations
  1. 1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
  2. 2Department of Cardiology, Hospital Bichat Claude-Bernard, Paris, France
  3. 3Department of Cardiology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
  4. 4Department of Cardiology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
  5. 5Department of Cardiology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
  6. 6Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
  7. 7Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
  8. 8Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
  9. 9Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Address correspondence to: Josep Rodés-Cabau, MD, PhD, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
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Abstract

Background: Patients with pre-existing right bundle branch block (RBBB) undergoing transcatheter aortic valve replacement (TAVR) are at a high risk of complete heart block, often requiring prolonged temporary pacing. Conventional temporary pacing leads are associated with lead dislodgement, immobilization, and intensive care unit (ICU) monitoring. The objective of this study was to compare screw-in versus conventional temporary pacing leads after TAVR in patients with pre-existing RBBB. Methods: This multicenter observational study included consecutive patients with pre-existing RBBB undergoing TAVR between 2018 and 2024. Patients receiving left ventricular pacing or no postprocedural temporary pacing were excluded. Outcomes included procedural complications, ICU utilization, hospital stay, permanent pacemaker implantation, and 30-day clinical events. Results: Among 544 patients, 124 received a screw-in lead and 420 a conventional lead. Screw-in leads were associated with significantly lower ICU utilization after TAVR (23% vs. 99%, p < 0.001). Despite longer temporary pacing duration (2.4 ± 1.4 days vs. 1.2 ± 1.6 days, p < 0.001), lead dislodgement was infrequent and numerically lower with screw-in leads (0.8% vs. 3.3%). Rates of major vascular complications, bleeding, tamponade, and atrial fibrillation were similar between groups. At 30 days, permanent pacemaker implantation rates were comparable (50.0% vs. 46.2%; p = 0.455), whereas hospital stay was shorter with screw-in leads (5.2 ± 4.2 days vs. 7.4 ± 7.8 days, p < 0.001). Mortality and major adverse events were similar. Conclusions: In TAVR recipients with pre-existing RBBB, screw-in temporary pacing leads were associated with reduced ICU utilization and shorter hospitalization without increasing complications or adverse outcomes, supporting their use for prolonged postprocedural monitoring.

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Cite

BibTeXRIS
BibTeX
@article{quentinfischer2026temporary,
  title = {{Temporary Active Fixation Leads in Transcatheter Aortic Valve Replacement Patients With Baseline Right Bundle Branch Block}},
  author = {Quentin Fischer, MD and Marina Urena, MD, PhD and Lluis Asmarats, MD, PhD and Gabriela Veiga Fernandez, MD, PhD and Victoria Vilalta, MD, PhD and Luis Nombela-Franco, MD, PhD and Guillem Muntané-Carol, MD, PhD and Ander Regueiro, MD, PhD and François Philippon, MD and Josep Rodés-Cabau, MD, PhD},
  journal = {Structural Heart},
  year = {2026},
  month = aug,
  doi = {10.1016/j.shj.2026.101119},
  url = {https://doi.org/10.1016/j.shj.2026.101119},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Temporary Active Fixation Leads in Transcatheter Aortic Valve Replacement Patients With Baseline Right Bundle Branch Block
AU  - Quentin Fischer, MD
AU  - Marina Urena, MD, PhD
AU  - Lluis Asmarats, MD, PhD
AU  - Gabriela Veiga Fernandez, MD, PhD
AU  - Victoria Vilalta, MD, PhD
AU  - Luis Nombela-Franco, MD, PhD
AU  - Guillem Muntané-Carol, MD, PhD
AU  - Ander Regueiro, MD, PhD
AU  - François Philippon, MD
AU  - Josep Rodés-Cabau, MD, PhD
PY  - 2026
DA  - 2026/08/26
JO  - Structural Heart
DO  - 10.1016/j.shj.2026.101119
UR  - https://doi.org/10.1016/j.shj.2026.101119
AB  - Background: Patients with pre-existing right bundle branch block (RBBB) undergoing transcatheter aortic valve replacement (TAVR) are at a high risk of complete heart block, often requiring prolonged temporary pacing. Conventional temporary pacing leads are associated with lead dislodgement, immobilization, and intensive care unit (ICU) monitoring. The objective of this study was to compare screw-in versus conventional temporary pacing leads after TAVR in patients with pre-existing RBBB. Methods: This multicenter observational study included consecutive patients with pre-existing RBBB undergoing TAVR between 2018 and 2024. Patients receiving left ventricular pacing or no postprocedural temporary pacing were excluded. Outcomes included procedural complications, ICU utilization, hospital stay, permanent pacemaker implantation, and 30-day clinical events. Results: Among 544 patients, 124 received a screw-in lead and 420 a conventional lead. Screw-in leads were associated with significantly lower ICU utilization after TAVR (23% vs. 99%, p < 0.001). Despite longer temporary pacing duration (2.4 ± 1.4 days vs. 1.2 ± 1.6 days, p < 0.001), lead dislodgement was infrequent and numerically lower with screw-in leads (0.8% vs. 3.3%). Rates of major vascular complications, bleeding, tamponade, and atrial fibrillation were similar between groups. At 30 days, permanent pacemaker implantation rates were comparable (50.0% vs. 46.2%; p = 0.455), whereas hospital stay was shorter with screw-in leads (5.2 ± 4.2 days vs. 7.4 ± 7.8 days, p < 0.001). Mortality and major adverse events were similar. Conclusions: In TAVR recipients with pre-existing RBBB, screw-in temporary pacing leads were associated with reduced ICU utilization and shorter hospitalization without increasing complications or adverse outcomes, supporting their use for prolonged postprocedural monitoring.
SN  - 2474-8706
SN  - 2474-8714
ER  -