Predictors of severe tricuspid regurgitation in patients with permanent pacemaker or automatic implantable cardioverter-defibrillator leads

Mohammad Q. Najib, Satya S. Vittala, Suresh Challa, Amol Raizada, Fernando J. Tondato, Howard R. Lee, Hari P Chaliki

Research output: Contribution to journalArticle

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Abstract

Patients with permanent pacemaker or automatic implantable cardioverter-defibrillator (AICD) leads have an increased prevalence of tricuspid regurgitation. However, the roles of cardiac rhythm and lead-placement duration in the development of severe tricuspid regurgitation are unclear. We reviewed echocardiographic data on 26 consecutive patients who had severe tricuspid regurgitation after permanent pacemaker or AICD placement; before treatment, they had no organic tricuspid valve disease, pulmonary hypertension, left ventricular dysfunction, or severe tricuspid regurgitation. We compared the results to those of 26 control subjects who had these same devices but no more than mild tricuspid regurgitation. The patients and control subjects were similar in age (mean, 81 ± 6 vs 81 ± 8 yr; P=0.83), sex (male, 42% vs 46%; P=0.78), and left ventricular ejection fraction (0.60 ± 0.06 vs 0.58 ± 0.05; P=0.4). The patients had a higher prevalence of atrial fibrillation (92% vs 65%; P=0.01) and longer median duration of pacemaker or AICD lead placement (49.5 vs 5 mo; P <0.001). After adjusting for age, sex, and right ventricular systolic pressure by multivariate logistic regression analysis, we found that atrial fibrillation (odds ratio=6.4; P=0.03) and duration of lead placement (odds ratio=1.5/yr; P=0.001) were independently associated with severe tricuspid regurgitation. Out study shows that atrial fibrillation and longer durations of lead placement might increase the risk of severe tricuspid regurgitation in patients with permanent pacemakers or AICDs.

Original languageEnglish (US)
Pages (from-to)529-533
Number of pages5
JournalTexas Heart Institute Journal
Volume40
Issue number5
StatePublished - 2013

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Tricuspid Valve Insufficiency
Implantable Defibrillators
Atrial Fibrillation
Odds Ratio
Tricuspid Valve
Left Ventricular Dysfunction
Ventricular Pressure
Pulmonary Hypertension
Stroke Volume
Logistic Models
Regression Analysis
Blood Pressure
Equipment and Supplies
Lead

Keywords

  • Artificial/adverse effects
  • Atrial fibrillation/complications
  • Cardiac pacing
  • Defibrillators
  • Disease progression
  • Echocardiography
  • Electrodes
  • Implantable/adverse effects
  • Implanted/adverse effects
  • Pacemaker
  • Right/diagnosis/etiology
  • Risk factors
  • Tricuspid valve insufficiency/diagnosis/etiology
  • Ventricular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of severe tricuspid regurgitation in patients with permanent pacemaker or automatic implantable cardioverter-defibrillator leads. / Najib, Mohammad Q.; Vittala, Satya S.; Challa, Suresh; Raizada, Amol; Tondato, Fernando J.; Lee, Howard R.; Chaliki, Hari P.

In: Texas Heart Institute Journal, Vol. 40, No. 5, 2013, p. 529-533.

Research output: Contribution to journalArticle

Najib, Mohammad Q. ; Vittala, Satya S. ; Challa, Suresh ; Raizada, Amol ; Tondato, Fernando J. ; Lee, Howard R. ; Chaliki, Hari P. / Predictors of severe tricuspid regurgitation in patients with permanent pacemaker or automatic implantable cardioverter-defibrillator leads. In: Texas Heart Institute Journal. 2013 ; Vol. 40, No. 5. pp. 529-533.
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AU - Najib, Mohammad Q.

AU - Vittala, Satya S.

AU - Challa, Suresh

AU - Raizada, Amol

AU - Tondato, Fernando J.

AU - Lee, Howard R.

AU - Chaliki, Hari P

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N2 - Patients with permanent pacemaker or automatic implantable cardioverter-defibrillator (AICD) leads have an increased prevalence of tricuspid regurgitation. However, the roles of cardiac rhythm and lead-placement duration in the development of severe tricuspid regurgitation are unclear. We reviewed echocardiographic data on 26 consecutive patients who had severe tricuspid regurgitation after permanent pacemaker or AICD placement; before treatment, they had no organic tricuspid valve disease, pulmonary hypertension, left ventricular dysfunction, or severe tricuspid regurgitation. We compared the results to those of 26 control subjects who had these same devices but no more than mild tricuspid regurgitation. The patients and control subjects were similar in age (mean, 81 ± 6 vs 81 ± 8 yr; P=0.83), sex (male, 42% vs 46%; P=0.78), and left ventricular ejection fraction (0.60 ± 0.06 vs 0.58 ± 0.05; P=0.4). The patients had a higher prevalence of atrial fibrillation (92% vs 65%; P=0.01) and longer median duration of pacemaker or AICD lead placement (49.5 vs 5 mo; P <0.001). After adjusting for age, sex, and right ventricular systolic pressure by multivariate logistic regression analysis, we found that atrial fibrillation (odds ratio=6.4; P=0.03) and duration of lead placement (odds ratio=1.5/yr; P=0.001) were independently associated with severe tricuspid regurgitation. Out study shows that atrial fibrillation and longer durations of lead placement might increase the risk of severe tricuspid regurgitation in patients with permanent pacemakers or AICDs.

AB - Patients with permanent pacemaker or automatic implantable cardioverter-defibrillator (AICD) leads have an increased prevalence of tricuspid regurgitation. However, the roles of cardiac rhythm and lead-placement duration in the development of severe tricuspid regurgitation are unclear. We reviewed echocardiographic data on 26 consecutive patients who had severe tricuspid regurgitation after permanent pacemaker or AICD placement; before treatment, they had no organic tricuspid valve disease, pulmonary hypertension, left ventricular dysfunction, or severe tricuspid regurgitation. We compared the results to those of 26 control subjects who had these same devices but no more than mild tricuspid regurgitation. The patients and control subjects were similar in age (mean, 81 ± 6 vs 81 ± 8 yr; P=0.83), sex (male, 42% vs 46%; P=0.78), and left ventricular ejection fraction (0.60 ± 0.06 vs 0.58 ± 0.05; P=0.4). The patients had a higher prevalence of atrial fibrillation (92% vs 65%; P=0.01) and longer median duration of pacemaker or AICD lead placement (49.5 vs 5 mo; P <0.001). After adjusting for age, sex, and right ventricular systolic pressure by multivariate logistic regression analysis, we found that atrial fibrillation (odds ratio=6.4; P=0.03) and duration of lead placement (odds ratio=1.5/yr; P=0.001) were independently associated with severe tricuspid regurgitation. Out study shows that atrial fibrillation and longer durations of lead placement might increase the risk of severe tricuspid regurgitation in patients with permanent pacemakers or AICDs.

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KW - Implanted/adverse effects

KW - Pacemaker

KW - Right/diagnosis/etiology

KW - Risk factors

KW - Tricuspid valve insufficiency/diagnosis/etiology

KW - Ventricular dysfunction

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