Echocardiographic Assessment of Tricuspid Valve Regurgitation Induced by Temporary or Permanent Endocardial Leads in Patients Undergoing Catheter Ablation or Permanent Device Implantation.

Buikema, L. (2014) Echocardiographic Assessment of Tricuspid Valve Regurgitation Induced by Temporary or Permanent Endocardial Leads in Patients Undergoing Catheter Ablation or Permanent Device Implantation. thesis, Medicine.

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Abstract

Introduction: Small, retrospective studies have suggested that permanent pacemaker implantation may lead to tricuspid valve regurgitation (TR). However, little is known about the impact of temporary lead insertion during ablation procedures without permanent lead implantation. Hypothesis: We hypothesize that both permanent and temporary endocardial leads are associated with TR. Methods: We performed a retrospective study of consecutive patients who underwent first device or catheter ablation over a 12 month period at a single, tertiary care center. We analyzed patients who had pre- and post-procedure echocardiographic studies and assessed the degree of TR by transthoracic echocardiography based on the following categorical scale: none/trivial, mild, moderate and severe. Results: in the device group, 89/527 (17%) patients underwent pre- and post-procedure echocardiography. The degree of TR significantly increased post-permanent lead implantation: 9 improved, 46 unchanged and 34 worsened (p=0.005). There was no significant change in Left ventricular ejection fraction (LVEF), right ventricle (RV) size or RV function pre- versus post-procedure. In the ablation group, 66/514 patients (13%) underwent pre- and post-procedure echocardiography. There was no significant change in the degree of TR post-ablation: 8 improved, 48 unchanged and 10 worsened (p=0.306). There was no significant change in LVEF, RV size or RV function pre-versus post-procedure. Conclusion: Permanent endocardial lead implantation was associated with an increase in the degree of TR. By contrast, temporary lead insertion during ablation was not associated with changes in degree of TR. A large prospective study is needed to accurately define the incidence and exact mechanisms of permanent endocardial lead-related TR.

Item Type:	Thesis (Thesis)
Supervisor name:	Verhorst, P.M.J.
Supervisor name:	Dokainish, H. and Department of Cardiology and Hamilton Health Sciences McMaster University
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:50
Last Modified:	25 Jun 2020 10:50
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1142

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