Key result
Direct-visualization atrial leadless pacemaker implantation during tricuspid surgery avoids leads causing TR in ~40% of patients.
Why the study?
Leadless cardiac pacemakers offer an alternative to transvenous pacing systems to reduce lead-related complications, especially in patients with tricuspid valve disease or prior valve interventions where trans-tricuspid leads can cause significant tricuspid regurgitation.
Case Report
Direct-visualization implantation of an atrial leadless pacemaker during tricuspid valve surgery is proposed as a strategy to avoid trans-tricuspid lead-induced tricuspid regurgitation.
May reduce lead-related TR at TV surgery; hypothesis-generating and requires prospective validation before adoption.
Leadless cardiac pacemakers (LCPs) are an emerging alternative to transvenous pacing systems, offering the potential to reduce lead-related complications. (1) In particular, the avoidance of trans-tricuspid leads is desirable in patients with tricuspid valve (TV) disease or prior valve interventions. Chronic pacemaker leads crossing the tricuspid valve can precipitate significant tricuspid regurgitation (TR). Studies have reported pacemaker lead-induced TR in about 10–40% of patients due to mechanical leaflet interference or perforation.
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Mansouri et al. (2026) conducted a case report in Tricuspid valve disease. Direct-visualization implantation of an atrial leadless pacemaker was evaluated. Direct-visualization implantation of an atrial leadless pacemaker at tricuspid valve surgery avoids trans-tricuspid leads, which precipitate tricuspid regurgitation in 10-40% of patients.
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