Predictors of worsening TR severity after right ventricular lead placement: any added value by post-procedural fluoroscopy versus three -dimensional echocardiography?
Cardiovasc Ultrasound
; 19(1): 37, 2021 Nov 21.
Article
em En
| MEDLINE
| ID: mdl-34802441
ABSTRACT
BACKGROUND:
The effect of right ventricular (RV) leads on tricuspid valve has been already raised concerns, especially in terms of prognostic implication. For such assessment, three-dimensional transthoracic echocardiography (3D-TTE) has been used previously but there was no data on the use of post-procedural fluoroscopy in the literature.METHODS:
We prospectively enrolled 59 patients who underwent clinically indicated placement of pacemaker or implantable cardioverter defibrillator (ICD). Vena contracta (VC) and tricuspid regurgitation (TR) severity were measured using two-dimensional transthoracic echocardiography (2D-TTE) at baseline. Follow up 3D-TTE was performed 6 months after device implantation to assess TR severity and RV lead location.RESULTS:
Lead placement position in TV was defined in 51 cases.TR VC was increased after the lead placement, compared to the baseline study (VC 3.86 ± 2.32 vs 3.18 ± 2.39; p = 0.005), with one grade worsening in TR in 25.4% of cases. The mean changes in VC levels were 1.14 ± 0.67 mm. Among all investigated parameters, VC changes were predicted based on lead placement position only in 3D-TTE (p < 0.001) while the other variables including fluoroscopy parameters were not informative.CONCLUSION:
The RV Lead location examined by 3D-TTE seems to be a valuable parameter to predict the changes in the severity of the tricuspid regurgitation. Fluoroscopy findings did not improve the predictive performance, at least in short term follow up.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Tricúspide
/
Ecocardiografia Tridimensional
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article