Permanent Pacemaker Lead Entrapment: Role of the Transesophageal Echocardiography

Champagne, Jean; Poirier, Paul; Dumesnil, Jean G.; Desaulniers, Denis; Boudreault, Jean-Roch; O’Hara, Gilles; Gilbert, M.; Philippon, François

doi:10.1046/j.1460-9592.2002.01131.x

Cited by 15 publications

(14 citation statements)

References 12 publications

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“…Isolated case reports have been noted of entrapment of a PPM lead in the tricuspid apparatus during implantation, resulting in avulsion or laceration of the tricuspid valve leaflets upon removal of the PPM lead (6 -11) and case reports of perforation of a tricuspid valve leaflet by a PPM (Table 4) (12)(13)(14)(15)(16)(17)(18). Echocardiographic detection of tricuspid regurgitation in patients with a PPM has been reported (19).…”

Section: Discussionmentioning

confidence: 99%

Severe Symptomatic Tricuspid Valve Regurgitation Due to Permanent Pacemaker or Implantable Cardioverter-Defibrillator Leads

Lin¹,

Nishimura²,

Connolly³

et al. 2005

Journal of the American College of Cardiology

303

156

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Section: Discussionmentioning

confidence: 99%

Severe Symptomatic Tricuspid Valve Regurgitation Due to Permanent Pacemaker or Implantable Cardioverter-Defibrillator Leads

Lin¹,

Nishimura²,

Connolly³

et al. 2005

Journal of the American College of Cardiology

303

156

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“…Another mechanism is asynchrony, resulting from abnormal right ventricle (RV) activation from a pacemaker. This may resolve if the patient returns to his/her intrinsic rhythm . Kim and colleagues demonstrated that TR after ICD or PPM implantation is not related to an increase in pulmonary artery pressure …”

Section: Mechanismmentioning

confidence: 99%

Tricuspid Regurgitation in Patients With Pacemakers and Implantable Cardiac Defibrillators: A Comprehensive Review

Al-Bawardy

Krishnaswamy

Bhargava

et al. 2013

Clinical Cardiology

112

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Implantable cardiac devices, including defibrillators and pacemakers, may be the cause of tricuspid regurgitation (TR) or may worsen existing TR. This review of the literature suggests that TR usually occurs over time after lead implantation. Diagnosis by clinical exam and 2‐dimensional echocardiography may be augmented by 3‐dimensional echocardiography and/or computed tomography. The mechanism may be mechanical perforation or laceration of leaflets, scarring and restriction of leaflets, or asynchronized activation of the right ventricle. Pacemaker‐related TR might cause severe right‐sided heart failure, but data regarding associated mortality are lacking. This comprehensive review summarizes the data regarding incidence, mechanism, and treatment of lead‐related TR.

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“…Compared with transthoracic echocardiography, transesophageal echocardiography may be potentially useful in identifying PPM-lead-related TR. 21,22 However, Lin et al reported that transesophageal echocardiography was able to visualize the PPM or ICD leads as a cause of TR in only 45% of patients, 7 and on that basis they recommended the use of 3-DE to identify intracardiac lead routes.…”

Section: Study Limitationsmentioning

confidence: 99%

Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

Seo

Ishizu

Nakajima

et al. 2008

Circ J

104

111

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ignificant tricuspid regurgitation (TR) has been reported in patients with a permanent pacemaker (PPM), [1][2][3][4][5] and the leads of such a device or those of an implantable cardioverter defibrillator (ICD) can be the primary cause of symptomatic TR. 6,7 However, in the clinical setting, the diagnosis of lead-induced TR can be challenging because conventional 2-dimensional echocardiography (2-DE) has limitations in identifying the anatomical relationship between the lead and the tricuspid leaflets. 7 The 3-dimensional echocardiography (3-DE) has been recently developed for assessing tricuspid valve morphology and pathology, including TR, [8][9][10][11] and case reports on its utility in the diagnosis of PPM-and ICD-lead-related TR have been published. 12,13 However, the ability of 3-DE to identify both the anatomical lead route through the tricuspid valve and lead-induced valve malfunction has not been studied systematically. Methods Patient PopulationIn 87 patients with PPM, ICD or cardiac resynchroniza- Circulation Journal Vol.72, September 2008tion therapy device, 3-DE studies were performed to evaluate the route of the leads and the presence of lead-related TR (Table 1). The underlying cardiac disease for which PPM implantation was required was complete or advanced atrioventricular block in 28 patients and sick sinus syndrome, including slow atrial fibrillation, in 22 patients, and for ICD implantation it was primary or secondary prevention of fatal cardiac arrhythmias in 17 patients. Cardiac resynchronization therapy devices with or without ICD were implanted in 20 patients with advanced heart failure. The study was approved by the local research ethics committee, and all patients gave written informed consent. Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker LeadsYoshihiro Seo, MD; Tomoko Ishizu, MD; Hideki Nakajima, RDCS*; Yukio Sekiguchi, MD; Shigeyuki Watanabe, MD; Kazutaka Aonuma, MD Background This study evaluated the usefulness of 3-dimensional echocardiography (3-DE) for identifying permanent pacemaker (PPM) or implantable cardioverter defibrillator (ICD) lead-related symptomatic tricuspid regurgitation (TR). Methods and ResultsEighty-seven patients underwent 3-DE examination: 50 patients with PPM, 17 with ICD, and 20 with cardiac resynchronization therapy devices. TR severity was classified as trivial/mild, moderate, or severe according to the ratio of TR area to right atrium area. The 3-DE identified the lead route and position at the tricuspid valve in 82 patients (94.2%). In 5 patients, images without lead-induced artifacts could not be obtained. TR severity was trivial/mild in 50 patients, moderate in 20 patients, and severe in 12 patients. In all patients with trivial/mild TR and all but 1 patient with moderate TR, leads were positioned on the annulus side between leaflets. Lead-induced obstruction to tricuspid valve closing was identified in 1 patient with moderate TR and in 7 of 12 patients with severe TR: 4 patients had...

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Permanent Pacemaker Lead Entrapment: Role of the Transesophageal Echocardiography

Cited by 15 publications

References 12 publications

Severe Symptomatic Tricuspid Valve Regurgitation Due to Permanent Pacemaker or Implantable Cardioverter-Defibrillator Leads

Severe Symptomatic Tricuspid Valve Regurgitation Due to Permanent Pacemaker or Implantable Cardioverter-Defibrillator Leads

Tricuspid Regurgitation in Patients With Pacemakers and Implantable Cardiac Defibrillators: A Comprehensive Review

Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

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