Document Detail

Impact of transvenous ventricular pacing leads on tricuspid regurgitation in pediatric and congenital heart disease patients.
MedLine Citation:
PMID:  18040765     Owner:  NLM     Status:  MEDLINE    
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.
Gregory Webster; Renee Margossian; Mark E Alexander; Frank Cecchin; John K Triedman; Edward P Walsh; Charles I Berul
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Publication Detail:
Type:  Journal Article     Date:  2007-11-27
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  21     ISSN:  1572-8595     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-03-05     Completed Date:  2009-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-8     Citation Subset:  IM    
Department of Cardiology, Children's Hospital, Boston, 300 Longwood Ave., Boston, MA 02115, USA.
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MeSH Terms
Boston / epidemiology
Child, Preschool
Electrodes, Implanted / statistics & numerical data*
Heart Defects, Congenital / epidemiology*
Heart Failure / epidemiology*,  prevention & control*
Middle Aged
Pacemaker, Artificial / statistics & numerical data*
Retrospective Studies
Risk Assessment / methods*
Risk Factors
Treatment Outcome
Tricuspid Valve Insufficiency / epidemiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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