Permanent pacemaker implantation associated tricuspid regurgitation

Abstract

Objective To determine the prevalence of tricuspid regurgitation in patients with dual-chamber permanent pacemaker implantation. Methods This study included 153 patients undergoing permanent pacemaker implantation. All eligible candidates had baseline transthoracic echocardiography to rule out preexisting tricuspid regurgitation. Echocardiography across the tricuspid valve was repeated one month after permanent pacemaker implantation, and the frequency of significant tricuspid regurgitation was determined. The associations of potential effect modifiers (age, sex, height, body mass index categories, diabetes, and hypertension) with tricuspid regurgitation were assessed individually using simple and multivariable logistic regression models. Results After dual-chamber permanent pacemaker implantation, significant tricuspid regurgitation was present in 22 (15.8%) patients. Tricuspid regurgitation was significantly associated with body mass index >30 kg·m−2 (odds ratio = 32.84, 95% confidence interval: 1.26–853.82, p = 0.04). Conclusion Significant tricuspid regurgitation was present in substantial number of patients after dual-chamber pacemaker implantation and was independently associated with body mass index >30 kg·m−2.

Pacemaker following transcatheter aortic valve replacement and tricuspid regurgitation: A single‐center experience

“…Other mechanisms for pacemaker induced tricuspid regurgitation have been reported. [11][12][13][14] PPM mechanisms of TR may be secondary to pacemaker leads causing tethering of the septal leaflet along the tricuspid annulus thereby impairing leaflet coaptation and closure, lead entanglement, lead adherence, and less commonly leaflet perforation. 12,15 Additionally, asynchronous right ventricle (RV) pacing from abnormal RV activation from the PPM may manifest later in time as biventricular heart failure with RV cavitary dilatation and clinically significant TR.…”

“…Other mechanisms for pacemaker induced tricuspid regurgitation have been reported 11–14 . PPM mechanisms of TR may be secondary to pacemaker leads causing tethering of the septal leaflet along the tricuspid annulus thereby impairing leaflet coaptation and closure, lead entanglement, lead adherence, and less commonly leaflet perforation 12,15 .…”