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The Role of 6-Hour ECG in Patients with Left Bundle Branch Block After TAVI in Determining Same-Day Discharge

Lookup NU author(s): Muntaser Omari, Dr Richard Edwards, Dr Rajiv Das, Professor Azfar ZamanORCiD, Dr Mohammad Alkhalil

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2025 by the authors.Background: Left bundle branch block (LBBB) following trans-catheter aortic valve implantation (TAVI) has been excluded from same-day discharge. Early identification of patients with stable LBBB can help facilitate same-day discharge. We aim to assess the role of 6-hour ECG to determine development of LBBB in patients undergoing TAVI. Methods: This is a prospective single-centre study of patients who have LBBB following elective TAVI procedures. All patients underwent ECGs pre-TAVI, as well as immediately, 6 h, and 24 h post-TAVI. Changes in ECG were compared at 6 and 24 h with the one immediately post TAVI. Results: The study included 115 patients with uncomplicated procedures. The mean age was 81 ± 7 years, with 54% male. A self-expanding valve was used in 67% of patients. Following TAVI, prolongations of PR interval and QRS duration were dynamic and reduced at 6 h. The change in PR interval at 6 and 24 h was comparable [−11 (−20 to 3) vs. −2 (−24 to 16) ms, p = 0.18]. Similarly, there was no statistical difference in the change of QRS duration at 6 and 24 h compared to the ECG immediately post-TAVI [−10 (−40 to −2) vs. −7 (−34 to 0) ms, p = 0.055]. Changes in ECG were also comparable in patients undergoing balloon-expandable and self-expanding valves. Conclusions: The current study supports that 6-hour ECG has the potential to reduce the need for prolonged continuous monitoring post-TAVI. ECG at 6 h can help optimise patient flow and facilitate early discharge. Future studies with larger sample sizes are required to confirm our findings.

Publication metadata

Author(s): Omari M, Memon S, Stewart D, Ali M, Edwards R, Das R, Cartlidge T, Zaman A, Farag M, Alkhalil M

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Medicine

Year: 2025

Volume: 14

Issue: 15

Online publication date: 31/07/2025

Acceptance date: 26/07/2025

Date deposited: 01/09/2025

ISSN (electronic): 2077-0383

Publisher: MDPI

URL: https://doi.org/10.3390/jcm14155408

DOI: 10.3390/jcm14155408

Data Access Statement: Data are available from corresponding author on a reasonable request.

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