Clinical investigationFunctional effects of pacingThe Effect of Transvenous Pacemaker and Implantable Cardioverter Defibrillator Lead Placement on Tricuspid Valve Function: An Observational Study
Section snippets
Population
All patients who underwent placement of a transvenous permanent pacemaker (PPM) or ICD lead at our electrophysiology laboratory between January 1, 2000, and April 30, 2005, were considered for inclusion. Lead replacement procedures were not considered. Patients were included in the study if echocardiography data were available within 1 year before and after lead insertion. There were no other exclusion criteria. The study was approved by the New York University School of Medicine Institutional
Results
Pre- and postimplant echocardiograms were available for 248 patients (174 with PPM, 74 with ICD) who had a transvenous lead implanted at our institution within the defined time window.
The baseline characteristics of the study population are described in Table 1. The mean age of the population was 75.4 ± 13.4 years, and 59% were men. The median time from preimplantation echocardiogram to implantation was 7 days; the median time from implantation to postimplantation echocardiogram was 93 days.
Discussion
This study showed that worsening of TR associated with the implantation of transvenous pacemaker or ICD leads is common. Twenty-one percent of all patients with mild TR or less developed significant TR after the implantation in our study, including 5% who developed moderate-to-severe or severe TR. There was a statistically significant increase in the level of TR when all patients were considered.
It is noteworthy that a greater proportion of subjects with ICD implant had significant worsening of
Conclusion
Worsening of TR is common after transvenous lead placement and is more common after ICD than PPM insertion.
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