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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 April;164(2):109-12
Tricuspid insufficiency does not worsen with permanent implanted pacemaker leads
Kucukarslan N. 1, Kirilmaz A. 2, Ulusoy E. 2, Yokusoglu M. 3, Gramatnikovski N. 1, Ozal E. 1, Tatar H. 1
1 Department of Cardiovascular Surgery, GATA Military Medical Hospital, Ankara, Turkey;
2 Cardiology Section, GATA Haydarpasa Military Hospital, Istanbul, Turkey;
3 Department of Cardiology, GATA Military Medical Hospital, Ankara, Turkey
Aim. Data regarding tricuspid regurgitation (TR) in patients with implanted pacemakers (PM) are controversial. Interference between PM lead and tricuspid apparatus may cause TR. Our aim is to find out the degree of TR in a group of patients before and following PM implantation in a prospective manner.
Methods. The study group consisted of the patients referred for implantation of permanent PM or implantable cardioverter defibrillator (ICD). All patients underwent two-dimensional and Doppler echocardiographic evaluation before and after a median of 1±1 days following device implantation by using System V (GE Medical, Horten, Norway) with 2.5 MHz probe. The severity of TR was qualitatively classified into 4 groups as normal or trivial, mild, moderate and severe. All studies were reviewed for accuracy by a second independent observer.
Results. The study population consisted of 61 patients (mean age 53±8 years, 44 male) referred for PM (n=55) or ICD (n=6) implantation. Echocardiographic degree of TR was mild in 21 (70%), moderate in 7 (23%) and severe in 2 (7%) patients before PM implantation. Follow-ing device implantation, mild TR was noted in 23 (76%), moderate in 10 (33%) and severe in 2 (6%) cases. After the procedure, the TR severity was increased from normal/trivial to mild in 5 (16%) cases and from mild to moderate in 3 (10%). There was no worsening of the severity of regurgitation following implantation.
Conclusion. New or worsening tricuspid regurgitation is relatively rare after pacemaker implantation. It is not usually associated with an acute worsening or clinical deterioration, but echocardiographic follow-up is recommended to rule out other complications.