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Tricuspid valve regurgitation following temporary or permanent endocardial lead insertion, and the impact of cardiac resynchronization therapy.

Sadreddini M, Haroun MJ, Buikema L, Morillo C, Ribas S, Divakaramenon S, Connolly SJ, Nieuwlaat R, Lonn EM, Healey JS, Dokainish H - Open Cardiovasc Med J (2014)

Bottom Line: We hypothesized that permanent, but nottemporary endocardial leads, are associated with development of TR, and that CRT would prevent (physiologic) TR.In the 89 patients in the device group, the degree of TR significantly increased ≥ 1 grade post-permanent lead implantation: 9 had less TR, 46 were unchanged, and 34 had more TR(p=0.005).TR increased in the 62 patients who underwent device implantation without CRT (p=0.005), but did not increase in the 27 patients with CRT (p=0.47).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

ABSTRACT

Background: While some studies indicate that permanent pacemaker implantation is associated with development of tricuspid regurgitation (TR), other studies indicate no association.Little is known about the impact of temporary lead insertion during ablation procedures, or whether therapy (CRT) prevents TR post-device implantation.

Hypothesis: We hypothesized that permanent, but nottemporary endocardial leads, are associated with development of TR, and that CRT would prevent (physiologic) TR.

Methods: We performed a retrospective study of consecutive patients who underwent first device or radiofrequency catheter ablation over a 12-month period at a single, tertiary academic center who underwent pre- and post-procedure echocardiography.

Results: In the 89 patients in the device group, the degree of TR significantly increased ≥ 1 grade post-permanent lead implantation: 9 had less TR, 46 were unchanged, and 34 had more TR(p=0.005). TR increased in the 62 patients who underwent device implantation without CRT (p=0.005), but did not increase in the 27 patients with CRT (p=0.47). In the 66 patients in the ablation group, there was no significant change in TR post-ablation: 8 had less TR, 48 were unchanged, and 10 had more TR (p=0.31).

Conclusion: Permanent endocardial lead implantation was associated with an increase in TR; however, patients who underwent device implantation with CRT did not have an increase in TR.Temporary lead insertion during ablation was not associated with changes in the degree of TR. A large, prospective study is needed to accurately define the incidence and exact mechanisms of permanent endocardial lead-related TR.

No MeSH data available.


Related in: MedlinePlus

Tricuspid Valve Regurgitation Pre- and Post-Permanent Device Implantation. There was a significant increase in the degree of tricuspid regurgitation from pre- to post-device (permanent pacemaker, implantable cardiac defibrillator or biventricular pacemaker] insertion (p=0.005).
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Figure 1: Tricuspid Valve Regurgitation Pre- and Post-Permanent Device Implantation. There was a significant increase in the degree of tricuspid regurgitation from pre- to post-device (permanent pacemaker, implantable cardiac defibrillator or biventricular pacemaker] insertion (p=0.005).

Mentions: In patients undergoing permanent device implantation, the degree of TR increased in 34 patients, decreased in 9 patients, and was unchanged in 46 patients (p=0.005 for comparison) (Table 2, Fig. 1).While the 42 patients who underwent device implantation without CRT had a significant increase in TR (p=0.005), the 27 patients who underwent device implantation with CRT had no significant increase in TR (p=0.47) (Table 3). In the device group, there was no significant difference in right ventricular size or systolic function (p=0.68 and p=0.42 respectively), left ventricular ejection fraction (37.9%±3.7vs. 37.5%±4.5, p=0.82) or left sided valve disease observed (Table 4).


Tricuspid valve regurgitation following temporary or permanent endocardial lead insertion, and the impact of cardiac resynchronization therapy.

Sadreddini M, Haroun MJ, Buikema L, Morillo C, Ribas S, Divakaramenon S, Connolly SJ, Nieuwlaat R, Lonn EM, Healey JS, Dokainish H - Open Cardiovasc Med J (2014)

Tricuspid Valve Regurgitation Pre- and Post-Permanent Device Implantation. There was a significant increase in the degree of tricuspid regurgitation from pre- to post-device (permanent pacemaker, implantable cardiac defibrillator or biventricular pacemaker] insertion (p=0.005).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321203&req=5

Figure 1: Tricuspid Valve Regurgitation Pre- and Post-Permanent Device Implantation. There was a significant increase in the degree of tricuspid regurgitation from pre- to post-device (permanent pacemaker, implantable cardiac defibrillator or biventricular pacemaker] insertion (p=0.005).
Mentions: In patients undergoing permanent device implantation, the degree of TR increased in 34 patients, decreased in 9 patients, and was unchanged in 46 patients (p=0.005 for comparison) (Table 2, Fig. 1).While the 42 patients who underwent device implantation without CRT had a significant increase in TR (p=0.005), the 27 patients who underwent device implantation with CRT had no significant increase in TR (p=0.47) (Table 3). In the device group, there was no significant difference in right ventricular size or systolic function (p=0.68 and p=0.42 respectively), left ventricular ejection fraction (37.9%±3.7vs. 37.5%±4.5, p=0.82) or left sided valve disease observed (Table 4).

Bottom Line: We hypothesized that permanent, but nottemporary endocardial leads, are associated with development of TR, and that CRT would prevent (physiologic) TR.In the 89 patients in the device group, the degree of TR significantly increased ≥ 1 grade post-permanent lead implantation: 9 had less TR, 46 were unchanged, and 34 had more TR(p=0.005).TR increased in the 62 patients who underwent device implantation without CRT (p=0.005), but did not increase in the 27 patients with CRT (p=0.47).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

ABSTRACT

Background: While some studies indicate that permanent pacemaker implantation is associated with development of tricuspid regurgitation (TR), other studies indicate no association.Little is known about the impact of temporary lead insertion during ablation procedures, or whether therapy (CRT) prevents TR post-device implantation.

Hypothesis: We hypothesized that permanent, but nottemporary endocardial leads, are associated with development of TR, and that CRT would prevent (physiologic) TR.

Methods: We performed a retrospective study of consecutive patients who underwent first device or radiofrequency catheter ablation over a 12-month period at a single, tertiary academic center who underwent pre- and post-procedure echocardiography.

Results: In the 89 patients in the device group, the degree of TR significantly increased ≥ 1 grade post-permanent lead implantation: 9 had less TR, 46 were unchanged, and 34 had more TR(p=0.005). TR increased in the 62 patients who underwent device implantation without CRT (p=0.005), but did not increase in the 27 patients with CRT (p=0.47). In the 66 patients in the ablation group, there was no significant change in TR post-ablation: 8 had less TR, 48 were unchanged, and 10 had more TR (p=0.31).

Conclusion: Permanent endocardial lead implantation was associated with an increase in TR; however, patients who underwent device implantation with CRT did not have an increase in TR.Temporary lead insertion during ablation was not associated with changes in the degree of TR. A large, prospective study is needed to accurately define the incidence and exact mechanisms of permanent endocardial lead-related TR.

No MeSH data available.


Related in: MedlinePlus