Document Detail

Clinical utility of 3-dimensional echocardiography in the evaluation of tricuspid regurgitation caused by pacemaker leads.
MedLine Citation:
PMID:  18724023     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study evaluated the usefulness of 3-dimensional echocardiography (3-DE) for identifying permanent pacemaker (PPM) or implantable cardioverter defibrillator (ICD) lead-related symptomatic tricuspid regurgitation (TR). METHODS AND RESULTS: Eighty-seven patients underwent 3-DE examination: 50 patients with PPM, 17 with ICD, and 20 with cardiac resynchronization therapy devices. TR severity was classified as trivial/mild, moderate, or severe according to the ratio of TR area to right atrium area. The 3-DE identified the lead route and position at the tricuspid valve in 82 patients (94.2%). In 5 patients, images without lead-induced artifacts could not be obtained. TR severity was trivial/mild in 50 patients, moderate in 20 patients, and severe in 12 patients. In all patients with trivial/mild TR and all but 1 patient with moderate TR, leads were positioned on the annulus side between leaflets. Lead-induced obstruction to tricuspid valve closing was identified in 1 patient with moderate TR and in 7 of 12 patients with severe TR: 4 patients had septal leaflet obstruction, and 4 had posterior leaflet obstruction. CONCLUSIONS: The 3-DE can identify the lead route and position at the tricuspid valve and lead-related severe TR, so may be a useful technique of diagnosing the cause of severe TR in patients with PPM or ICD.
Yoshihiro Seo; Tomoko Ishizu; Hideki Nakajima; Yukio Sekiguchi; Shigeyuki Watanabe; Kazutaka Aonuma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1465-70     Citation Subset:  IM    
Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Clinical Laboratory, Tsukuba University Hospital, Tsukuba, Japan.
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MeSH Terms
Aged, 80 and over
Echocardiography, Three-Dimensional / methods*
Middle Aged
Pacemaker, Artificial / adverse effects*
Tricuspid Valve / physiopathology,  ultrasonography*
Tricuspid Valve Insufficiency / etiology,  physiopathology,  therapy,  ultrasonography*

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