Key result
CIED implantation linked to tricuspid regurgitation in up to ~45%, increasing mortality and HF risk.
Why the study?
CIED-related tricuspid regurgitation carries substantial prognostic risk and presents major management challenges, necessitating a review of its mechanisms, clinical importance, and management.
Does cardiac implantable electronic device implantation increase the risk of tricuspid regurgitation, heart failure hospitalization, and all-cause mortality in adult patients?
Does cardiac implantable electronic device implantation increase the risk of tricuspid regurgitation, heart failure hospitalization, and all-cause mortality in adult patients?
This narrative review highlights that tricuspid regurgitation associated with cardiac implantable electronic devices is a common complication independently linked to increased mortality and heart failure hospitalization, requiring careful implantation techniques and individualized management.
The use of cardiac implantable electronic devices (CIEDs) has increased considerably, becoming a cornerstone of management for patients with brady- or tachyarrhythmia or for the prevention of sudden cardiac death. On the other hand, tricuspid regurgitation (TR) associated with CIEDs is progressively accepted as a serious clinical issue; the prognostic impact of TR is profound, as it is independently associated with increased mortality and a higher risk of heart failure hospitalization. Additionally, the management of established CIED-related TR continues to be challenging, with limited options for intervention once significant TR has developed. The balance between the lifesaving benefits of CIEDs and the risk of TR underlines the necessity for cautious patient selection and innovative approaches to device implantation and management. This review highlights the clinical importance, underlying mechanisms and challenges associated with lead-related tricuspid regurgitation in patients with CIEDs.
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Iliescu et al. (2024) conducted a review in Cardiac implantable electronic device (CIED)-associated and CIED-related tricuspid regurgitation. Cardiac implantable electronic device (CIED) implantation vs. No CIED implantation or absence of post-CIED tricuspid regurgitation was evaluated. Cardiac implantable electronic device implantation is associated with a 7.2% to 44.7% incidence of tricuspid regurgitation, which independently increases mortality and heart failure hospitalization risk.
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