title: A new view of an unusual pacemaker complication: role of three-dimensional transthoracic echocardiography.
abstract: Tricuspid regurgitation (TR) produced by endocavitary leads (EL) from permanent pacemakers and implantable cardiac defibrillators is a well-known complication of this procedure. The EL may damage or interfere with tricuspid valve function causing mechanical interference of the valve leaflets leading to incomplete valve closure. It is important to recognize this mechanical complication because it could be corrected by repositioning the lead. In this case report we demonstrate how three-dimensional transthoracic echocardiography permits to obtaining an en face view, which allows simultaneous visualization of the 3 moving leaflets during the cardiac cycle, their attachment to the tricuspid annulus and the pattern of leaflet coaptation. Thus, we propose three-dimensional transthoracic echocardiography as the tool of choice to evaluate TR related to EL, to evaluate the necessity of repositioning the lead if severe regurgitation or tricuspid valve malfunction are demonstrated.
authors.affiliation: Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil. marcelohaertel@gmail.com
authors.forename: Marcelo Haertel
authors.initials: MH
authors.lastname: Miglioranza
authors.forename: Derly
authors.initials: D
authors.lastname: Becker
authors.forename: José-Julio
authors.initials: JJ
authors.lastname: Jiménez-Nácher
authors.forename: José Luis
authors.initials: JL
authors.lastname: Moya
authors.forename: Covadonga Fernandez
authors.initials: CF
authors.lastname: Golfin
authors.forename: José Luis
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D000368:Aged; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control
keywords: echocardiography; endocavitary leads; pacemaker; three-dimensional echocardiography; tricuspid regurgitation