October 28, 2020Open Access

Progressive Tricuspid Regurgitation and Elevated Tricuspid Regurgitation Pressure Gradient after Transvenous Permanent Pacemaker Implantation

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Why the study?

The association between post-implant tricuspid regurgitation and heart failure hospitalization in patients without heart failure or preexisting abnormal tricuspid regurgitation and pressure gradient remained unclear.

Does progressive tricuspid regurgitation after transvenous permanent pacemaker implantation increase the risk of heart failure hospitalization in patients without preexisting heart failure?

Population

1,075 transvenous permanent pacemaker recipients without prior heart failure or baseline abnormal TR/TRPG

Comparison

Progressive post-implant TR and/or elevated TRPG vs no progressive post-implant TR

Design

Single-center observational cohort study

Authors

WLWei‐Chieh LeeElectrophysiology HFHsiu‐Yu FangInterventional Cardiology HCHuang‐Chung ChenElectrophysiology

Discussion

Member takes

Implication

Progressive post-implant TR may signal higher HF hospitalization risk after PPM; hypothesis-generating and should not yet change practice.

Structured PICO

Does progressive tricuspid regurgitation after transvenous permanent pacemaker implantation increase the risk of heart failure hospitalization in patients without preexisting heart failure?

Population

1,075 patients who underwent a single ventricular or dual-chamber transvenous permanent pacemaker (PPM) implantation. Excluded: severe valvular heart disease, prior valvular surgery, heart failure, LVEF <50%, dilated/hypertrophic cardiomyopathy, and preexisting abnormal TR and abnormal (>30 mmHg) TRPG.

Intervention

Transvenous permanent pacemaker (PPM) implantation (single ventricular or dual-chamber) with development of progressive post-implant tricuspid regurgitation (increased TR grade of ≥2 degrees and/or TRPG of >30 mmHg).

Comparator

Patients who underwent transvenous permanent pacemaker implantation but did not develop progressive post-implant tricuspid regurgitation.

Outcome

TR progression (TR grade ≥3) and/or abnormal TRPG levels (PG >30 mmHg)surrogate

Progressive tricuspid regurgitation occurs in 18.4% of patients after transvenous permanent pacemaker implantation and is associated with an increased risk of heart failure hospitalization.

Limitations

Retrospective nature
Data from only one medical center
Absence of baseline and follow-up right heart size and function by echocardiography

Cite This Study

Lee et al. (2020) studied this question.

synapsesocial.com/papers/6a764f210d7658322f06e185 https://doi.org/10.21203/rs.3.rs-58129/v2

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Implication

Progressive post-implant TR may signal higher HF hospitalization risk after PPM; hypothesis-generating and should not yet change practice.

Progressive Tricuspid Regurgitation and Elevated Tricuspid Regurgitation Pressure Gradient after Transvenous Permanent Pacemaker Implantation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Progressive Tricuspid Regurgitation and Elevated Tricuspid Regurgitation Pressure Gradient after Transvenous Permanent Pacemaker Implantation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider