Biventricular or Left Bundle Branch Pacing to Assess the Effect of Cardiac Resynchronization Therapy in Patients Undergoing Transcatheter Aortic Valve Implantation

Inclusion criteria

• Age over 18 years
• Successful and complication-free TAVI implantation for significant aortic stenosis
• Signed informed consent after detailed patient information
• New-onset LBBB wider than 130 ms after TAVI, persisting at the time of planned discharge (assessed postoperatively on or after day 5)(21)
• Mildly reduced left ventricular systolic function on echocardiography at the planned time of discharge (at the earliest on postoperative day 5), with EF between 35% and 55%

Exclusion criteria

• Pre-existing right bundle branch block, or prior pacemaker/ICD implantation associated with significant (>20%) ventricular pacing

• Progression of LBBB during hospitalization to a degree indicating pacemaker implantation (e.g., Mobitz II or third-degree AV block, alternating bundle branch block) before the planned discharge date
• Concomitant severe valvular disease of other valves (mitral, pulmonary, or tricuspid)
• Severe infection and/or septic state
• TAVI-associated stroke
• More than moderate paravalvular leak of the TAVI valve on postoperative echocardiography
• EF < 35% or > 55% on echocardiography performed at the planned time of discharge
• GOLD stage IV COPD
• Chronic renal failure requiring regular dialysis
• Concurrent participation in another clinical trial