title: Tricuspid regurgitation in patients with pacemakers and implantable cardiac defibrillators: a comprehensive review.
abstract: 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.
authors.affiliation: Department Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Rasha
authors.initials: R
authors.lastname: Al-Bawardy
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.forename: Mandeep
authors.initials: M
authors.lastname: Bhargava
authors.forename: Justin
authors.initials: J
authors.lastname: Dunn
authors.forename: Oussama
authors.initials: O
authors.lastname: Wazni
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.forename: William
authors.initials: W
authors.lastname: Stewart
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000401:mortality; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D003952:Diagnostic Imaging / Q000379:methods; D004554:Electric Countershock / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D006801:Humans; D015994:Incidence; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy