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Open Access 01-06-2021 | Echocardiography | Original Paper

Pacemaker lead-associated tricuspid regurgitation in patients with or without pre-existing right ventricular dilatation

Authors: Martin Riesenhuber, Andreas Spannbauer, Marianne Gwechenberger, Thomas Pezawas, Christoph Schukro, Günter Stix, Matthias Schneider, Georg Goliasch, Anahit Anvari, Thomas Wrba, Cesar Khazen, Martin Andreas, Günther Laufer, Christian Hengstenberg, Mariann Gyongyosi

Published in: Clinical Research in Cardiology | Issue 6/2021

Abstract

Background

Transcatheter tricuspid valve intervention became an option for pacemaker lead-associated tricuspid regurgitation. This study investigated the progression of tricuspid regurgitation (TR) in patients with or without pre-existing right ventricular dilatation (RVD) undergoing pacemaker implantation.

Methods

Patients were included if they had implantation of transtricuspid pacemaker lead and completed echocardiography before and after implantation. The cohort was divided in patients with and without RVD (cut-off basal RV diameter ≥ 42 mm). TR was graded in none/mild, moderate, and severe. Worsening of one grade was defined as progression. Survival analyses were plotted for 10 years.

Results

In total, 990 patients were analyzed (24.5% with RVD). Progression of TR occurred in 46.1% of patients with RVD and in 25.6% of patients without RVD (P < 0.001). Predictors for TR progression were RV dilatation (OR 2.04; 95% CI 1.27–3.29; P = 0.003), pre-existing TR (OR 4.30; 95% CI 2.51–7.38; P < 0.001), female sex (OR 1.68; 95% CI 1.16–2.43; P = 0.006), single RV lead (OR 1.67; 95% CI 1.09–2.56; P = 0.018), mitral regurgitation (OR 2.08; 95% CI 1.42–3.05; P < 0.001), and enlarged left atrium (OR 1.98; 95% CI 1.07–3.67; P = 0.03). Survival-predictors were pacemaker lead-associated TR (HR 1.38; 95% CI 1.04–1.84; P = 0.028), mitral regurgitation (HR 1.34; 95% CI 1.02–1.77; P = 0.034), heart failure (HR 1.75; 95% CI 1.31–2.33; P < 0.001), kidney disease (HR 1.62; 95% CI 1.25–2.11; P < 0.001), and age ≥ 80 years (HR 2.84; 95% CI 2.17–3.71; P < 0.001).

Conclusions

Patients with RVD receiving pacemaker suffered from increased TR progression, leading to decreased survival.

Graphic abstract

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Title: Pacemaker lead-associated tricuspid regurgitation in patients with or without pre-existing right ventricular dilatation
Authors: Martin Riesenhuber
Andreas Spannbauer
Marianne Gwechenberger
Thomas Pezawas
Christoph Schukro
Günter Stix
Matthias Schneider
Georg Goliasch
Anahit Anvari
Thomas Wrba
Cesar Khazen
Martin Andreas
Günther Laufer
Christian Hengstenberg
Mariann Gyongyosi
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Echocardiography
Echocardiography
Conventional Pacemaker
Conventional Pacemaker
Pacemaker
Pacemaker
Pacemaker
Published in: Clinical Research in Cardiology / Issue 6/2021
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01812-3

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Pacemaker lead-associated tricuspid regurgitation in patients with or without pre-existing right ventricular dilatation

Abstract

Background

Methods

Results

Conclusions

Graphic abstract

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