Single-center randomized trial in patients with pacing indication (AV block) after TAVI (transfemoral aortic valve implantation) and LVEF\> 50%, that aims to study the percentage of patients who improve at 12 months in a combined clinical endpoint.
Successful implantation of TAVI according to VARC-3 criteria.
Indication of cardiac pacing due to AV block according to ESC Guidelines.
LVEF> 50%.
The patient must indicate their acceptance to participate in the study by signing an informed consent document.
Ventricular dysfunction: LVEF <50%.
Transapical TAVI.
Participating currently in a clinical investigation that includes an active treatment.
Patients with left bundle branch block but without indication of pacing (AV block).
Parallel
Conduction system pacing
Procedure/SurgeryLeft bundle branch pacing or His bundle branch pacing
Right ventricular pacing
Procedure/SurgeryConventional pacing
Clinical combined endpoint: survival; and improvement > 1 point in NYHA class or > 25% increase in the distance covered in the 6-minute walking test.
Determine the percentage of patients who improve at 12 months on a clinical combined endpoint: survival; and improvement \> 1 point in NYHA class or \> 25% increase in the distance covered in the 6-minute walking test.
Change in left ventricular ejection fraction.
Left ventricular ejection fraction (LVEF %) measured with Simpson method with echocardiography (Delta left ventricular ejection fraction: 12 months LVEF - baseline LVEF).
Correction of echocardiographic asynchrony: septal flash expressed in mm.
Correction of septal flash determined with echocardiography (M mode).
Distance covered in the 6-minute walking test.
Distance in meters walked in 6 minutes.
Change in NYHA (New York Heart Association) functional class.
NYHA functional class I, II, III, IV.
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