Leon Sophie A, Austin Melissa, Nasher Nayeem, Rahimov Daler, Siddique Faizaan, Parikh Chitra, Ahmad Danial, Tchantchaleishvili Vakhtang, Pavri Behzad B
Department of Cardiac Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USA.
Division of Cardiology, Department of Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania USA.
J Arrhythm. 2025 Jul 7;41(4):e70133. doi: 10.1002/joa3.70133. eCollection 2025 Aug.
Placement of cardiac implantable electronic devices (CIED) with leads that traverse the tricuspid valve is thought to contribute to tricuspid regurgitation (TR). However, there are relatively limited data comparing the impact of different CIED lead types on the incidence and progression of TR. This study sought to quantify the change in TR severity following implantation of CIEDs with different lead types.
Patient data were collected on individuals with implantable cardioverter defibrillators (ICD), right ventricular-paced pacemakers (RV-PM), and His bundle-paced pacemakers (His-PM) placed by a single provider at a single institution between 2016 and 2019. Patients with extravascular CIED placement or with existing devices undergoing upgrade procedures were excluded. Severity of TR after CIED implantation was compared to baseline TR.
A total of 97 patients receiving CIEDs were analyzed, including 63 with RV-PMs, 23 with ICDs, and 11 with His-PMs. Median patient age was 72 [interquartile range (IQR) 63-81] years, and 44% of patients were female. Echocardiograms were obtained a median of 20 [4-91] days before CIED implantation and 31 [17.9-43.0] months following implantation. Baseline TR grade was comparable between groups ( = 0.65). TR severity significantly worsened after ICD implantation ( = 0.035), RV-PM implantation trended toward worsening TR severity ( = 0.099), and no statistically significant difference was observed after His-PM implantation ( = 0.68).
The effect of CIED leads on TR represents a spectrum related to the type of lead traversing the tricuspid valve.
带有穿过三尖瓣导线的心脏植入式电子设备（CIED）的植入被认为会导致三尖瓣反流（TR）。然而，比较不同类型CIED导线对TR发生率和进展影响的数据相对有限。本研究旨在量化植入不同类型导线的CIED后TR严重程度的变化。
收集了2016年至2019年期间由单一机构的单一提供者植入植入式心律转复除颤器（ICD）、右心室起搏起搏器（RV-PM）和希氏束起搏起搏器（His-PM）的患者数据。排除血管外CIED植入患者或正在进行设备升级程序的现有设备患者。将CIED植入后的TR严重程度与基线TR进行比较。
共分析了97例接受CIED的患者，其中63例植入RV-PM，23例植入ICD，11例植入His-PM。患者中位年龄为72岁[四分位间距（IQR）63 - 81岁]，44%为女性。在CIED植入前中位数20天[4 - 91天]和植入后31个月[17.9 - 43.0个月]获得超声心动图。各组间基线TR分级相当（P = 0.65）。ICD植入后TR严重程度显著恶化（P = 0.035），RV-PM植入后TR严重程度有恶化趋势（P = 0.099），His-PM植入后未观察到统计学显著差异（P = 0.68）。
CIED导线对TR的影响代表了与穿过三尖瓣的导线类型相关的一个范围。
