Incidence and Predictors of Acute Tricuspid Regurgitation Worsening After Left Bundle Branch Area Pacing

Figures

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  Central Figure.

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  Figure 1.. Echocardiographic assessment of lead-to-tricuspid valve distance and septal lead position. (A) Representative echocardiographic image showing measurement of the lead-to-tricuspid valve distance, defined as the distance from the tricuspid annulus to the lead insertion site. The tricuspid annulus and the LBBAP lead are indicated. (B) Representative echocardiographic image illustrating visual classification of septal lead position as basal, mid or apical according to the location of the lead insertion site along the interventricular septum. LBBAP, left bundle branch area pacing.

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  Figure 2.. Transition and distribution of tricuspid regurgitation (TR) grade before and after left bundle branch area pacing. (A) Stacked bar charts showing the overall distribution of TR grade at baseline and at the early postprocedural assessment in 239 patients. Acute TR worsening, defined as an increase of ≥1 grade, was observed in 27 patients (11.3%). (B) Transition matrix of TR grade from baseline to the early postprocedural echocardiographic assessment within 1 week after implantation. Numbers indicate the number of patients in each category. Diagonal cells indicate unchanged TR grade, cells above the diagonal indicate worsening, and cells below the diagonal indicate improvement.

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  Figure 3.. Association of septal lead position with acute tricuspid regurgitation (TR) worsening and lead-to-tricuspid valve distance. (A) Incidence of acute TR worsening according to septal lead position (basal, mid or apical). (B) Lead-to-tricuspid valve (TV) distance according to septal lead position. Data are presented as box-and-whisker plots overlaid with individual data points; the box indicates the interquartile range, the horizontal line indicates the median, and the whiskers indicate the range. P values indicate overall comparisons among 3 groups.