Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiac stimulation system implantation (n=100). Intervention: Insufficient endocardial lead length vs. Optimal lead position. Primary outcome: Severe tricuspid regurgitation (OR 3.914, p=0.003).

Anna Rydlewska; Andrzej Ząbek; Krzysztof Boczar; Jacek Lelakowski; Barbara Małecka

doi:10.5114/pwki.2017.68073

January 1, 2017Advances in Interventional CardiologyOpen Access

Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem

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Key result

Insufficient endocardial lead length (OR 3.914) and excessive lead length (OR 2.595) on chest X-ray were significantly associated with severe tricuspid regurgitation.

Figures

Why the study?

Does non-optimal radiological endocardial lead position increase the risk of severe tricuspid regurgitation in patients with cardiac stimulation systems?

Study Design

Type

Cross-Sectional (n=100)

Multicenter

No

Structured PICO

Does non-optimal radiological endocardial lead position increase the risk of severe tricuspid regurgitation in patients with cardiac stimulation systems?

P

Population

100 consecutive patients with implanted cardiac stimulation systems (mean age 67.1 years, 34% female) evaluated for tricuspid regurgitation during routine follow-up at a mean of 9 years post-implantation.

E

Exposure

Non-optimal radiological endocardial lead position (excessive or insufficient lead length assessed via chest X-ray)

C

Comparator

Optimal radiological endocardial lead position (free transition through right heart chambers and tricuspid valve as an arch facing the diaphragm)

O

Outcome

Presence of severe tricuspid regurgitation evaluated by transthoracic echocardiographysurrogate

Main Result

Odds Ratio: 3.914

Absolute Event Rate: 42.8% vs 5.6%

p-value: p=0.003

Limitations

Lack of pre-procedural full echocardiographic study and repeated echocardiographic examinations.
Impossible to determine whether the observed radiological changes were present since implantation or developed over time.
Lack of pre-procedural full echocardiographic study
Lack of repeated echocardiographic examinations
Impossible to determine whether radiological changes were present since implantation or developed over time

Implication

Non-optimal radiological positioning of endocardial leads, particularly insufficient or excessive lead length, is strongly associated with the presence of severe tricuspid regurgitation.

Abstract

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Rydlewska A, Ząbek A, Boczar K, Lelakowski J, Małecka B. Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2017;13(2):165-169. doi:10.5114/pwki.2017.68073. APA Rydlewska, A., Ząbek, A., Boczar, K., Lelakowski, J., & Małecka, B. (2017). Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 13(2), 165-169. https://doi.org/10.5114/pwki.2017.68073 Chicago Rydlewska, Anna, Andrzej Ząbek, Krzysztof Boczar, Jacek Lelakowski, and Barbara Małecka. 2017. "Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 13 (2): 165-169. doi:10.5114/pwki.2017.68073. Harvard Rydlewska, A., Ząbek, A., Boczar, K., Lelakowski, J., and Małecka, B. (2017). Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 13(2), pp.165-169. https://doi.org/10.5114/pwki.2017.68073 MLA Rydlewska, Anna et al. "Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 13, no. 2, 2017, pp. 165-169. doi:10.5114/pwki.2017.68073. Vancouver Rydlewska A, Ząbek A, Boczar K, Lelakowski J, Małecka B. Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2017;13(2):165-169. doi:10.5114/pwki.2017.68073.

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Cite This Study

Rydlewska et al. (2017) conducted a cross-sectional in Cardiac stimulation system implantation (n=100). Insufficient endocardial lead length vs. Optimal lead position was evaluated on Severe tricuspid regurgitation (OR 3.914, p=0.003). Insufficient endocardial lead length (OR 3.914) and excessive lead length (OR 2.595) on chest X-ray were significantly associated with severe tricuspid regurgitation.

synapsesocial.com/papers/6a9d9ed7894d4c85b98b1d15 https://doi.org/10.5114/pwki.2017.68073

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Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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