The effects of right ventricular apical pacing with transvenous pacemaker and implantable cardioverter defibrillator on mitral and tricuspid regurgitation

Fanari, Zaher; Hammami, Sumaya; Hammami, Muhammad M.; Hammami, Safa; Shuraih, Mossaab

doi:10.1016/j.jelectrocard.2015.07.002

Cited by 48 publications

(29 citation statements)

References 20 publications

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“…Pacing-related TR also one of the possible mechanism of PMTR. Since LV dyssynchrony and left bundle branch block is an established cause of mitral regurgitation [18], RV dyssynchrony due to permanent pacing is considered can lead to a worsening of TR [6]. In this study, atrial fibrillation and a history of open-heart surgery were found to be independent predictors of PMTR.…”

Section: Plos Onementioning

confidence: 65%

Prevalence, predictors, and prognosis of tricuspid regurgitation following permanent pacemaker implantation

et al. 2020

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This study aimed to investigate the prevalence and clinical significance of lead-related tricuspid regurgitation (TR) in patients with permanent pacemaker (PM). A total of 2,533 patients who underwent permanent PM implantation between January 2008 and December 2017 in a single center were retrospectively reviewed. Among them, 429 patients who underwent transthoracic echocardiography within 90 days before implantation and were followed up at least 3 months after PM implantation were included. Patients who had pre-existing grade 3 or 4 TR, had a single atrial lead, or had undergone tricuspid valve surgery before PM implantation were excluded. Occurrence of PM-related TR (PMTR) was defined as worsening of TR by at least 2 grades on follow-up echocardiography. Cardiovascular outcomes were defined as the composite of cardiovascular death and hospitalization for heart failure. During the median follow-up of 855 days, 42 (9.8%) patients had PMTR and 86 (20.0%) presented with cardiovascular outcomes. In the multivariate logistic regression analysis, the presence of atrial fibrillation (hazard ratio [HR]: 2.07, 95% confidence interval [CI]: 1.27-4.09, p = 0.037]) and history of open-heart surgery (HR: 3.34, 95% CI: 1.68-6.68, p<0.001) were independently associated with PMTR. Patients with PMTR showed significantly higher cardiovascular events than those without (45.2 vs. 17.3%, log-rank p<0.001). Furthermore, PMTR was independently associated with the primary outcome (HR: 2.45, 95% CI: 1.43-4.22, p = 0.001). In conclusion, the occurrence of TR in patients with permanent PM is not uncommon. PMTR is associated with atrial fibrillation, the history of openheart surgery, and poorer cardiovascular outcomes.

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Section: Plos Onementioning

confidence: 65%

Prevalence, predictors, and prognosis of tricuspid regurgitation following permanent pacemaker implantation

et al. 2020

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“…It is well established that chronic RV pacing can lead to abnormal left ventricular contraction and mitral regurgitation, raising the concern that changes affecting the left heart might be responsible for at least some of the TR that develops. Analysis of the PROTECT‐PACE population revealed that increased TR is strongly associated with deteriorations of LV function and noninvasive surrogate markers of increased LV filling pressure but not with signs of RV deterioration.…”

Section: Mechanisms Of Tv Dysfunctionmentioning

confidence: 99%

Severe tricuspid regurgitation due to interactions with right ventricular permanent pacemaker or defibrillator leads

Trankle

Gertz

Koneru

et al. 2018

Pacing Clinical Electrophis

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Although thought to be a rare event, permanent pacemakers and implantable cardioverter-defibrillators with right ventricular intracardiac leads have the potential to induce tricuspid valve dysfunction. Adverse lead-valve interactions can take place through a variety of mechanisms including damage at the time of implantation, leaflet pinning, or long-term fibrosis encapsulating the leaflet tissue. Clinical manifestations can display a wide range of severity, as well as a highly variable time span between implantation and hemodynamic deterioration. This review aims to describe the potential pathophysiologic effects of intracardiac device leads on the tricuspid valve, with a focus on ideal diagnostic strategies and treatment options once lead-induced valvular dysfunction is suspected.

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“…The previous transvenous leads might help worsening the severity of the TR owing to the mechanical interferences with the tricuspid valve closure. 23 These anatomical remodeling in the right atrium might allow for a safer manipulation of the LP catheter system. 12 The LP may have several advantages in considering it as a re-implantation strategy in octogenarians.…”

Section: Lp Implantation In Octogenariansmentioning

confidence: 99%

Leadless pacemaker implantations after infectious pacemaker removals in octogenarians

Higuchi

Shoda

Daigo

et al. 2020

Preprint

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Background: Management of pacemaker (PM) infections in patients with an advanced age is one of the most sensitive issues, since they possess particular clinical challenges due to higher rates of medical comorbidities. The novel leadless pacemaker (LP) requiring no transvenous lead or device pocket, may provide new opportunities for the management of PM infections among patients with an advanced age. Methods: We reviewed 8 octogenarians (median age of 86 [minimum 82-maximum 90], male 63%) who received an LP implantation following a transvenous lead extraction (TLE) of an infectious PM. Results: All patients had more than 2 medical comorbidities. The indications for the LP implantations were atrioventricular block in 3 patients, atrial fibrillation bradycardia in 3, and sinus node dysfunction in 2. Five patients were bridged with a temporary pacing using an active fixation lead (median interval of 14.5 days), while one patient with severe dementia underwent a concomitant LP implantation and TLE during the same procedure. Successful TLEs and LP implantations were accomplished in all patients. There were no major or minor complications including vascular access troubles. All patients were discharged 2-8 days after the implantation. All patients stayed free of infection during the follow-up period of 6 months Conclusions: LP implantations were safe and effective after infected pacemaker removals in all 8 octogenarians. The novel LP technology may offer an alternative option in considering re-implantation of a PM even among patients with an advanced age and who are PM dependent.

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The effects of right ventricular apical pacing with transvenous pacemaker and implantable cardioverter defibrillator on mitral and tricuspid regurgitation

Cited by 48 publications

References 20 publications

Prevalence, predictors, and prognosis of tricuspid regurgitation following permanent pacemaker implantation

Prevalence, predictors, and prognosis of tricuspid regurgitation following permanent pacemaker implantation

Severe tricuspid regurgitation due to interactions with right ventricular permanent pacemaker or defibrillator leads

Leadless pacemaker implantations after infectious pacemaker removals in octogenarians

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