{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T03:25:49Z","timestamp":1792898749514,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016304","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016304","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Meril and Novo Nordisk"},{"DOI":"10.13039\/100000046","name":"Abbott","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000046","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008497","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BioSensors and OrbusNeich"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In the largest nationwide study of Danish patients undergoing transcatheter aortic valve implantation, we examined the clinical impact of pre-existing right bundle branch block \u2013 a known risk factor for permanent pacemaker implantation \u2013 on outcomes including pacemaker implantation, heart failure, and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We included first-time transcatheter aortic valve implantation patients in Denmark from 2008 to 2021. Patients were stratified by baseline right bundle branch block status using the digital Danish Nationwide Electrocardiogram Cohort. The study outcomes were new pacemaker implantation, heart failure, and all-cause mortality at 30, 90, and 365 days. A composite of the study outcomes was also assessed. A total of 4900 patients were included, of whom 438 (9%) had baseline right bundle branch block. Mean age was 81 years, 55% were male. At 90 days, the overall pacemaker implantation incidence was 9%, but markedly higher in the right bundle branch block group: 28.3% vs. 7.1% [hazard ratio (HR) 4.61, 95% confidence interval (CI) 3.60\u20135.91]. Right bundle branch block was not associated with higher rates of heart failure (10.1% vs. 8.3%; HR 1.23, 95% CI 0.86\u20131.77) or death (3.7% vs. 3.6%; HR 1.08, 95% CI 0.64\u20131.82). The findings were consistent at 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this comprehensive nationwide cohort, right bundle branch block strongly predicted pacemaker implantation after transcatheter aortic valve implantation but importantly, not heart failure or all-cause mortality. The neutral association with heart failure and mortality should be explored further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag004","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:43:48Z","timestamp":1768394628000},"source":"Crossref","is-referenced-by-count":2,"title":["Baseline right bundle branch block and clinical outcomes in patients undergoing transcatheter aortic valve implantation: a Danish nationwide cohort study"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-7353","authenticated-orcid":false,"given":"Daniel K","family":"Steiner","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]},{"name":"Department of Cardiothoracic Surgery, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria L","family":"Krogager","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]},{"name":"Department of Cardiology, Regional Hospital of Northern Jutland , Bispensgade 37, 9800 Hj\u00f8rring ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoffer","family":"Polcwiartek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9650-9781","authenticated-orcid":false,"given":"Claus","family":"Graff","sequence":"additional","affiliation":[{"name":"Aalborg University, Department of Science Health and Technology , Selma Lagerl\u00f8fs Vej 249, 9260 Gistrup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle C","family":"Christensen","sequence":"additional","affiliation":[{"name":"The Prehospital Center, University Hospital of Copenhagen , Ringstedsgade 61, 4700 Naestved ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel P","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nordsj\u00e6llands Hospital , Dyrehavevej 29, 3400 Hiller\u00f8d ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J","family":"Terkelsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evald H","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9414-1653","authenticated-orcid":false,"given":"Jens C","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads B","family":"Kronborg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders M","family":"Sommer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troels","family":"Thim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ellert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital , J.B. Winsl\u00f8wsvej 4, 5000 Odense C ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens B","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital , J.B. Winsl\u00f8wsvej 4, 5000 Odense C ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gintautas","family":"Bieliauskas","sequence":"additional","affiliation":[{"name":"Copenhagen Heart Center , Blegdamsvej 9, 2100 Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"De Backer","sequence":"additional","affiliation":[{"name":"Copenhagen Heart Center , Blegdamsvej 9, 2100 Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-688X","authenticated-orcid":false,"given":"Michael","family":"Vinther","sequence":"additional","affiliation":[{"name":"Copenhagen Heart Center , Blegdamsvej 9, 2100 Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Simonsen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1849-9463","authenticated-orcid":false,"given":"Sam","family":"Riahi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe J","family":"Riddersholm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nordsj\u00e6llands Hospital , Dyrehavevej 29, 3400 Hiller\u00f8d ,","place":["Denmark"]},{"name":"Department of Public Health, University of Copenhagen , \u00d8ster Farimagsgade 5, 1353 K\u00f8benhavn K ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian Hay","family":"Kragholm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan","family":"Eftekhari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"key":"2026021103064195600_oeag004-B1","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1093\/eurheartj\/ehaf194","article-title":"2025 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"46","author":"Praz","year":"2025","journal-title":"Eur Heart J"},{"key":"2026021103064195600_oeag004-B2","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N Engl J Med"},{"key":"2026021103064195600_oeag004-B3","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N Engl J Med"},{"key":"2026021103064195600_oeag004-B4","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.amjcard.2023.11.024","article-title":"Temporal trends in patient characteristics and outcomes of transcatheter aortic valve implantation and surgical aortic valve replacement: a nationwide study","volume":"211","author":"Lundahl","year":"2024","journal-title":"Am J Cardiol"},{"key":"2026021103064195600_oeag004-B5","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/europace\/euq094","article-title":"Electrocardiographic and further predictors for permanent pacemaker requirement after transcatheter aortic valve implantation","volume":"12","author":"Erkapic","year":"2010","journal-title":"Europace"},{"key":"2026021103064195600_oeag004-B6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jacc.2014.04.033","article-title":"Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR A meta-analysis","volume":"64","author":"Siontis","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026021103064195600_oeag004-B7","first-page":"144","article-title":"Trends in the occurrence of new conduction abnormalities after transcatheter aortic valve implantation","volume":"85","author":"Van Der Boon","year":"2015","journal-title":"Catheter Cardiovasc Interv"},{"key":"2026021103064195600_oeag004-B8","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/j.jcin.2021.03.043","article-title":"Prophylactic permanent pacemaker implantation in patients with right bundle branch block undergoing TAVR","volume":"14","author":"Fukutomi","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2026021103064195600_oeag004-B9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1403494811401482","article-title":"The Danish national patient register","volume":"39","author":"Lynge","year":"2011","journal-title":"Scand J Public Health"},{"key":"2026021103064195600_oeag004-B10","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/1403494810394717","article-title":"The Danish national prescription registry","volume":"39","author":"Wallach Kildemoes","year":"2011","journal-title":"Scand J Public Health"},{"key":"2026021103064195600_oeag004-B11","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s10654-014-9930-3","article-title":"The Danish civil registration system as a tool in epidemiology","volume":"29","author":"Schmidt","year":"2014","journal-title":"Eur J Epidemiol"},{"key":"2026021103064195600_oeag004-B12","doi-asserted-by":"crossref","first-page":"e012832","DOI":"10.1136\/bmjopen-2016-012832","article-title":"Positive predictive value of cardiovascular diagnoses in the Danish national patient registry: a validation study","volume":"6","author":"Sundb\u00f8ll","year":"2016","journal-title":"BMJ Open"},{"key":"2026021103064195600_oeag004-B13","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s10654-024-01105-9","article-title":"The Danish nationwide electrocardiogram (ECG) cohort","volume":"39","author":"Polcwiartek","year":"2024","journal-title":"Eur J Epidemiol"},{"key":"2026021103064195600_oeag004-B14"},{"key":"2026021103064195600_oeag004-B15","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1136\/bmj.d124","article-title":"Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study","volume":"342","author":"Olesen","year":"2011","journal-title":"BMJ"},{"key":"2026021103064195600_oeag004-B16","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1002\/bimj.201800298","article-title":"On the estimation of average treatment effects with right-censored time to event outcome and competing risks","volume":"62","author":"Ozenne","year":"2020","journal-title":"Biom J"},{"key":"2026021103064195600_oeag004-B17","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.2147\/CLEP.S423587","article-title":"The Danish national child health register","volume":"15","author":"Andersen","year":"2023","journal-title":"Clin Epidemiol"},{"key":"2026021103064195600_oeag004-B18","doi-asserted-by":"crossref","first-page":"e0253332","DOI":"10.1371\/journal.pone.0253332","article-title":"Right bundle branch block is not associated with worse short- and mid-term outcome after transcatheter aortic valve implantation","volume":"16","author":"Weferling","year":"2021","journal-title":"PLoS One"},{"key":"2026021103064195600_oeag004-B19","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1016\/j.jcin.2016.08.035","article-title":"Pre-existing right bundle branch block increases risk for death after transcatheter aortic valve replacement with a balloon-expandable valve","volume":"9","author":"Watanabe","year":"2016","journal-title":"JACC Cardiovasc Interv"},{"key":"2026021103064195600_oeag004-B20","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/j.jcin.2017.05.030","article-title":"Clinical impact of baseline right bundle branch block in patients undergoing transcatheter aortic valve replacement","volume":"10","author":"Auffret","year":"2017","journal-title":"JACC Cardiovasc Interv"},{"key":"2026021103064195600_oeag004-B21","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.jcin.2023.03.021","article-title":"Impact of high implantation of transcatheter aortic valve on subsequent conduction disturbances and coronary access","volume":"16","author":"Ochiai","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2026021103064195600_oeag004-B22","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/j.jcin.2020.04.015","article-title":"Impact of left ventricular outflow tract calcification on procedural outcomes after transcatheter aortic valve replacement","volume":"13","author":"Okuno","year":"2020","journal-title":"JACC Cardiovasc Interv"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeag004\/66430887\/oeag004.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/1\/oeag004\/66430887\/oeag004.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/1\/oeag004\/66430887\/oeag004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T08:06:51Z","timestamp":1770797211000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeag004\/8427479"}},"subtitle":[],"editor":[{"given":"Patrizio","family":"Lancellotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeag004","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1]]},"article-number":"oeag004"}}