Key result
Leadless pacemakers avoid transvenous lead complications following bioprosthetic tricuspid valve replacement.
Why the study?
In patients with bioprosthetic tricuspid valve replacement, transvenous lead placement for pacemakers is discouraged due to risks of valve damage, infection, and other complications.
Case Report
Leadless pacemakers may offer a safer alternative to transvenous leads in patients with bioprosthetic tricuspid valves by avoiding valve damage and reducing infection risks.
May support leadless pacing post-bioprosthetic tricuspid replacement; hypothesis-generating and requires prospective comparative studies.
In patients undergoing bioprosthetic tricuspid valve (BTV) replacement, the incidence of atrioventricular (AV) block and need for pacemaker implantation is high.1–3 In these patients, placement of transvenous leads is discouraged since leads crossing the BTV may lead to valve damage or dysfunction; furthermore, in many of these patients, the indication for BTV is frequently recent or ongoing infection, and placement of transvenous leads may increase this risk. Finally, placement of transvenous leads adds risks of pneumothorax, hemothorax, and cardiac perforation, as well as chronic postoperative complications including increased risk of deep vein thrombosis, lead dislodgement, and lead fracture, in addition to the aforementioned risk of infections.
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Evan Aders (2024) conducted a case report in Bioprosthetic tricuspid valve (BTV) replacement. Leadless pacemaker implantation vs. Transvenous leads was evaluated. Leadless pacemaker implantation avoids the risks of valve damage, infection, and other complications associated with transvenous leads in patients with bioprosthetic tricuspid valve replacement.
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