Novel Anatomic Predictors of New Persistent Left Bundle Branch Block After Evolut Transcatheter Aortic Valve Implantation.

•New-persistent LBBB (NP-LBBB) is associated with adverse outcomes with few known predictors.•Independent predictors of NP-LBBB after Evolut TAVI were shorter MSL, LVOT eccentricity, annular perimeter oversizing and NCC depth.•We found an escalating risk of NP-LBBB with multiple predictors.•MSL ≤6.5 mm, LVOT eccentricity ≥35%, annular perimeter oversizing ≥20% and NCC depth ≥3 mm were optimal threshold values to predict NP-LBBB.•Integrating MSL in decision-making can reduce the incidence of NP-LBBB after Evolut TAVI.•NP-LBBB risk can be mitigated in patients with short MSL, by a more aortic deployment or less annular oversizing.