Cardiac Pacemaker and the Effect on Hemodynamics of the Tricuspid Valve
Journal Title: Journal of Clinical Medical Research - Year 2024, Vol 5, Issue 3
Abstract
Placement of ICDs, permanent pacemakers and biventricular devices is performed under fluoroscopic guidance. Implantable device leads can cause Tricuspid Regurgitation (TR) when they interfere with leaflet motion. In our clinical experience, we had two cases where patients with endocardial right ventricle leads developed severe TR. One patient was treated by having his leads repositioned and the other required surgery. This study analyzed the grade of tricuspid regurgitation before and after implantation of lead pacmencker in Right Ventrecle. Aim: Evaluation of tricuspid regurgitation after right ventricular permanent lead implantation to check if echocardiographic guidance is needed for adequate lead positioning. Methods: 76 patients had trans-thoracic Doppler echocardiographic studies before and after implantation of permanent right ventricular leads. Results: Before Right Ventricular (RV) lead implantation, 96% of patients had Tricuspid Regurgitation (TR). Patients were stratified by grade of regurgitation. 57 patients were grade 1 (75%), 12 (16%) were grade 2 and 4 were grade 3 or 4 (5%). After RV lead implantation, 44 patients with grade 1 TR remained with the same degree (77%) while in 2 (3.5%) TR progressed to grade 2 and in the remainder the TR disappeared. Most of the patients with grade 2 TR before RV lead implantation (75%) remained in grade 2 while 25% the grade decreased to grade 1. In all the patients with grade 3 and 4 TR pre-implantation, the severity of TR decreased by one grade. In 56 patients with non-CRT device implantations, 39 (70%) had grade 1 TR before procedure. After implantation, 28 (72%) of them did not change grade and 11 (28%) progressed to grade 2. Regarding grade 2 TR before implantation in 8 patients (14%) – the TR grade decreased in 3 (37.5%) and did not change in the others. In 3 (5.4%) patients with grade 3 and 4 TR before the procedure, the TR decreased after procedure. Conclusion: Implantation of permanent RV leads did not worsen TR grade.
Authors and Affiliations
Haydar Moahammad1,2,3*, Bezlel Roy1, Elliott Cohen1, Uriel Levinger1, 3, Ibrahim Majdoub2
Keywords
Related Articles
- EP ID EP743969
- DOI https://doi.org/10.46889/JCMR.2024.5301
- Views 25
- Downloads 0
Assessment of Renal Function Tests and Serum Total Protein among Pregnant Women with Pregnancy-Induced Hypertension Attending in Asrade Zewudie Memorable Hospital (ASZMPH), Gojjam, Ethiopia: Case-Control Study
Background: Pregnancy-induced hypertension has remained a significant global public health threat in both developed and developing countries. Therefore, this study aimed to assess renal function tests and serum total p...
Efficacy of Resin-Modified Glass Ionomer Cement Varnish and Sodium Fluoride Varnish in The Prevention of White Spot Lesions During Fixed Orthodontic Treatment- A Split Mouth Study
Objective: Evaluating efficacy of Resin-Modified Glass Ionomer Varnish and Sodium Fluoride Varnish in prevention of White Spot Lesions (WSLs) during early fixed orthodontic treatment; comparing the incidence of white spo...
From Discomfort to Delight: Diet's Impact on IBS-D
Introduction: IBS-D is a common gastrointestinal illness that causes lower abdominal discomfort, bloating, changed bowel patterns and poor quality of life. Despite no physical or biochemical problems, IBS-D is debilitati...
Histopathological Pattern of Lupus Nephritis for Implication to Treatment in a Tertiary Care Hospital, Dhaka, Bangladesh
Background: Lupus Nephritis (LN) is one of the more common and serious manifestations of Systemic Lupus Erythematosus (SLE). It is regarded as both a strong predictor and a leading cause for morbidity and mortality among...
The Study of Relationship between Plasma Fibrinogen Level and the Macrovascular Complications in Type 2 Diabetes Mellitus patients in a Tertiary Health Care Centre in Eastern India
Introduction: The macrovascular complications in patients of Type 2 Diabetes Mellitus (T2DM) are an expression of the generalized atherosclerotic process affecting the blood vessels of the body. Studies have revealed car...