Left vs. Normal QRS Axis During Left Bundle Branch Block Induced by Transcatheter Aortic Valve Replacement ― 3-Year Outcomes ―

Background: The clinical impact of left QRS axis deviation (LAD) during new-onset left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) remains unclear. Methods and Results: was associated with a higher incidence of permanent pacemaker implantation (PPI) for atrioventricular conduction disorder (16% vs. 6%; P=0.02) and remained an independent predictor of PPI (Cox hazard ratio 2.46; 95% CI 1.06-5.73; P=0.04). Echocardiographic measures, including left ventricular ejection fraction, chamber size, and mitral regurgitation severity showed no significant longitudinal differences between groups. Conclusions: is associated with an increased need for PPI, but not with adverse mortality or heart failure outcomes at 3-year follow-up. Closer and extended rhythm monitoring may be warranted in this subgroup.