Key result
His bundle pacing improves tricuspid regurgitation grade with a negligible ~5% incidence of new TR.
Why the study?
This systematic review aimed to explore the association of new tricuspid regurgitation and its quantification in patients undergoing His bundle pacing.
Does His bundle pacing cause new or worsening tricuspid regurgitation in patients requiring pacing?
Systematic Review (n=546)
Does His bundle pacing cause new or worsening tricuspid regurgitation in patients requiring pacing?
His bundle pacing does not appear to cause significant new tricuspid regurgitation and may improve TR grade in patients receiving it for CRT or AV block.
Supports His bundle pacing to minimize tricuspid regurgitation risk; extends safety evidence across CRT and AV block populations.
OBJECTIVE: This systematic review aimed to explore an association of new TR and its quantification in patients undergoing His bundle pacing (HBP). METHODS: A literature review was conducted using Mesh terms (His bundle pacing, tricuspid regurgitation, tricuspid valve incompetence, etc.) in PubMed, EMBASE, Web of science CINAHL, and the Cochrane Library till October 2021. Relevant studies evaluating tricuspid regurgitation in HBP were included and information regarding TR and its related factors (ejection fraction (EF) and New York Heart Association (NYHA) class) were retrieved from the eligible studies. RESULTS: Out of 196 articles, 10 studies met the inclusion criteria, which consisted of 546 patients with HBP. The mean age of the patients ranged between 61.2 ± 12.3 and 75.1 ± 7.9 years with 54.1% males. The overall implant success rate was 79.2%. Only one study reported a 5% incidence of TR, while 9 studies reported no new TR after HBP. Four studies reported overall decrease in TR by 1 grade and 3 studies demonstrated increased TR from baseline. Two studies showed no change from baseline TR. CONCLUSION: HBP causes improvement in TR grade after HBP for cardiac resynchronization therapy (CRT) as well as atrioventricular block (AVB). Further studies in the form of randomized controlled trials are required to further evaluate the effect of HBP on tricuspid valve functioning.
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Zaidi et al. (2022) conducted a systematic review in Tricuspid regurgitation in patients undergoing His bundle pacing (n=546). His bundle pacing (HBP) vs. Baseline (pre-implantation) was evaluated on Assessment of TR grade or incidence of new TR after HBP implantation. His bundle pacing improved tricuspid regurgitation grade from baseline and was associated with a negligible 0% to 5% incidence of new tricuspid regurgitation.
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