What is the clinical evidence from this study?

Study design: Case Report. Population: Symptomatic bradycardia with a transcatheter bicaval system (n=1). Intervention: Left-sided transvenous pacemaker implantation. Primary outcome: Procedural success and stable function.

What does this research mean for the field?

Left-sided transvenous pacemaker implantation through a bicaval TricValve prosthesis is feasible and can achieve stable long-term pacing without compromising lead or valve integrity. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report the first successful left-sided pacemaker implantation through a bicaval tricuspid prosthesis.

July 10, 2026Pacing and Clinical Electrophysiology

First Report of Left‐Sided Transvenous Pacemaker Implantation Through a Bicaval TricValve Prosthesis

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Key result

Left-sided pacemaker through a tricuspid bicaval prosthesis maintains stable 10-month function without valve damage.

Why the study?

Experience with permanent pacing in patients with bicaval prostheses for torrential tricuspid regurgitation remains extremely limited.

Can a left-sided transvenous pacemaker be safely implanted through a bicaval TricValve prosthesis in a patient with symptomatic bradycardia?

Population

One 83-year-old woman with a bicaval prosthesis who developed symptomatic bradycardia

Design

Case report

Follow-up

10-month

Authors

PSP SpadaroOspedale San Paolo PRPietro RicciardiMarzano Research (United States)MCMassimo CavallaroUniversity of Leicester

Discussion

Member takes

Implication

Successful permanent pacing feasible with bicaval TR prostheses; extends limited experience to high-risk patients.

Key Points

To report the first successful left-sided pacemaker implantation through a bicaval tricuspid prosthesis.
An 83-year-old female with high surgical risk underwent transcatheter bicaval implantation for severe TR.
Ten months later, a left-sided pacemaker was implanted via the left subclavian vein after confirming vein drainage with venography.
Pre-procedural imaging and careful lead navigation were performed to ensure safety and valve integrity.
Left-sided pacemaker implantation was successfully completed without damage to the prosthesis or lead.
Excellent electrical parameters were observed post-implantation.
Ten-month follow-up showed stable function and no complications.

Study Design

Type

Case Report (n=1)

Structured PICO

Can a left-sided transvenous pacemaker be safely implanted through a bicaval TricValve prosthesis in a patient with symptomatic bradycardia?

Population

An 83-year-old woman with a transcatheter bicaval system for torrential tricuspid regurgitation who underwent left-sided transvenous pacemaker implantation, followed for 10 months.

Intervention

Left-sided single-chamber transvenous pacemaker implantation through a tricuspid bicaval prosthesis via the left subclavian vein.

Outcome

Successful pacemaker implantation and stable function without lead or valve damage.safety

This first reported case demonstrates the feasibility and safety of left-sided transvenous pacemaker implantation through a bicaval TricValve prosthesis when venographic anatomy allows.

Cite This Study

Spadaro et al. (2026) conducted a case report in Symptomatic bradycardia with a transcatheter bicaval system (n=1). Left-sided transvenous pacemaker implantation was evaluated on Procedural success and stable function. Left-sided transvenous pacemaker implantation through a tricuspid bicaval prosthesis was successful, maintaining stable function without lead or valve damage at 10-month follow-up.

synapsesocial.com/papers/6a508d546eeac72a437a0e7d https://doi.org/10.1111/pace.70346

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