title: The effect of transvenous pacemaker and implantable cardioverter defibrillator lead placement on tricuspid valve function: an observational study.
abstract: This study assessed the effect of transtricuspid placement of permanent pacemaker (PPM) and implantable cardioverter defibrillator (ICD) leads on tricuspid regurgitation (TR) in 248 patients with echocardiograms before and after placement. Some 21.2% of patients with baseline mild TR or less developed abnormal TR (3.4% mild-moderate, 12.8% moderate, 1.1% moderate-severe, 3.9% severe) after implant. TR worsened by 1 grade or more after implant in 24.2% (20.7% of PPMs vs. 32.4% of ICDs; P < .05). TR worsening was more common with ICDs than PPMs in patients with baseline mild TR or less. After lead implantation, abnormal TR developed in 21.2% and severe TR developed in 3.9% of patients with initially normal TR. TR worsened by at least 1 grade in 24.2%. Patients with ICDs had a higher rate of TR worsening compared with patients with PPMs (32.4% vs. 20.1%; P < .05).
authors.affiliation: Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA.
authors.forename: Juyong B
authors.initials: JB
authors.lastname: Kim
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Spevack
authors.forename: Paul A
authors.initials: PA
authors.lastname: Tunick
authors.forename: John R
authors.initials: JR
authors.lastname: Bullinga
authors.forename: Itzhak
authors.initials: I
authors.lastname: Kronzon
authors.forename: Larry A
authors.initials: LA
authors.lastname: Chinitz
authors.forename: Harmony R
authors.initials: HR
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D004567:Electrodes, Implanted / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009518:New York / Q000453:epidemiology; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D019919:Prosthesis Implantation / Q000379:methods / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014463:Ultrasonography