Impact of transvenous ventricular pacing leads on tricuspid regurgitation in pediatric and congenital heart disease patients

Gregory Webster, Renee Margossian, Mark E. Alexander, Frank Cecchin, John K. Triedman, Edward P. Walsh, Charles I. Berul

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Introduction: Transvenous ventricular pacing leads across the tricuspid valve may cause or exacerbate tricuspid regurgitation (TR). The literature in adults is inconclusive and no studies have investigated the association between pacing leads and TR in children or congenital heart disease patients. Methods and results: A retrospective chart review was conducted at a large children's hospital, yielding 123 patients with initial placement of a transvenous lead across their tricuspid valve that had adequate echocardiographic data for review. The median age was 16 years (range 2-52) at time of lead placement. The pre-procedure echo was compared both to the first echo after lead placement and the most recent echo. Median time was 242 days from implant to first echo, and 827 days to most recent echo. There was no difference in TR between the pre-procedure echo and first follow-up echo (p=NS). However, TR was more likely to progress mildly between the pre-procedure echo and the most recent echo (p<0.02) with a mean increase from 1.54 to 1.69 on a 0 to 4 ordinal scale. There were 76 pts (62%) with CHD. Mean pre-procedure TR was 1.82 in right-sided valvular CHD (e.g., tetralogy of Fallot, repaired AV canal) vs. 1.43 without right-sided CHD (p<0.01). Conclusions: In patients with transvenous ventricular leads across the tricuspid valve, echocardiography demonstrates a small, but statistically significant change in TR. The detected change is minimal, suggesting that there is little impact of transvenous leads on TR, even in growing children or patients with right-sided structural heart disease.

Original languageEnglish (US)
Pages (from-to)65-68
Number of pages4
JournalJournal of Interventional Cardiac Electrophysiology
Volume21
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Cardiac growth
  • Echocardiogram
  • Implantable cardioverter-defibrillator (ICD)
  • Pacemaker
  • Pediatric
  • Transvenous
  • Tricuspid regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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