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Prior studies of tricuspid regurgitation (TR) after endocardial lead placement have been limited by small sample size and have been unable to identify predictors of its occurrence. This study sought to describe the incidence of worsening TR following implantation of endocardial leads for permanent pacemakers (PPM) and implantable cardioverter–defibrillators (ICD) and to identify clinical and echocardiographic risk factors that predict significantly increased TR follwing lead placement.
Patients (N=405) who received a PPM or ICD from 01/2006 to 12/2010, and had echocardiograms both within 1 year prior to and any time after device placement were included. TR was assessed on a 6–point scale (none/trace, mild, mild to moderate, moderate, moderate to severe, severe). The primary outcome was an increase in the severity of TR by 2 or more grades.
A significant increase in TR was seen in 52 (12.8%) patients. Table 1 shows pre–implant patient features grouped by the change in severity of TR with lead placement. Univariate predictors of increased TR were age and atrial fibrillation. In a multivariate analysis, pre–implant atrial fibrillation (odds ratio = 2.13, p=0.015, 95% confidence interval 1.16–3.96) was the only independent predictor.
The incidence of significant increased TR following endocardial lead placement was 12.8%; this is lower than prior estimates. Pre–implant atrial fibrillation predicts increased TR after lead placement.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Valvular Heart Disease: Clinical VIII
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1286–87
- 2013 American College of Cardiology Foundation