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Review
. 2013 May;36(5):249-54.
doi: 10.1002/clc.22104. Epub 2013 Mar 25.

Tricuspid regurgitation in patients with pacemakers and implantable cardiac defibrillators: a comprehensive review

Rasha Al-Bawardy  1 , Amar Krishnaswamy, Mandeep Bhargava, Justin Dunn, Oussama Wazni, E Murat Tuzcu, William Stewart, Samir R Kapadia
Affiliations
Review

Tricuspid regurgitation in patients with pacemakers and implantable cardiac defibrillators: a comprehensive review

Rasha Al-Bawardy et al. Clin Cardiol. 2013 May.

Abstract

Implantable cardiac devices, including defibrillators and pacemakers, may be the cause of tricuspid regurgitation (TR) or may worsen existing TR. This review of the literature suggests that TR usually occurs over time after lead implantation. Diagnosis by clinical exam and 2-dimensional echocardiography may be augmented by 3-dimensional echocardiography and/or computed tomography. The mechanism may be mechanical perforation or laceration of leaflets, scarring and restriction of leaflets, or asynchronized activation of the right ventricle. Pacemaker-related TR might cause severe right-sided heart failure, but data regarding associated mortality are lacking. This comprehensive review summarizes the data regarding incidence, mechanism, and treatment of lead-related TR.

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Figures

Figure 1
Figure 1
Mechanisms of mechanical tricuspid regurgitation in the setting of permanent pacemaker or implantable cardioverter‐defibrillator leads. (a) Valve obstruction caused by lead placed in between leaflets. (b) Lead adherence due to fibrosis and scar formation to valve causing incomplete closure. (c) Lead entrapment in the tricuspid valve apparatus. (d) Valve perforation or laceration. (e) Annular dilatation.
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References

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