Key result
LBBAP and jailed leads show stable valve and device function up to ~2.5 years after TTVI.
Why the study?
Atrioventricular conduction disturbances and CIED therapy are frequently required after TTVI, but the interaction between the annulus, transcatheter heart valve, and leads is complex and optimal management remains under debate.
Does left bundle branch area pacing and management of jailed leads provide stable device and valve function in patients undergoing transcatheter tricuspid valve implantation?
Observational (n=36)
Does left bundle branch area pacing and management of jailed leads provide stable device and valve function in patients undergoing transcatheter tricuspid valve implantation?
Left bundle branch area pacing (LBBAP) following transcatheter tricuspid valve implantation (TTVI) is feasible with stable device and valve function up to 2.5 years, and right ventricular lead-jailing showed no lead failure at one year.
Atrioventricular conduction disturbances and the need for cardiac implantable electronic device (CIED) therapy are frequently required after transcatheter tricuspid valve implantation (TTVI). The interaction between the annulus, transcatheter heart valve and the leads is often complex and the optimal management under debate. We prospectively included 36 patients undergoing TTVI between June 2021 and January 2025. 14 patients had a preexisting CIED. 11 patients experienced right ventricular lead‐jailing without signs for early or delayed lead failure after one year, one patient underwent lead extraction and two patients had a leadless pacemaker. In four patients, a pacemaker in LBBAP was successfully implanted due to new‐onset postoperative atrioventricular block. The device measurements as well as the valve function remained stable over a follow‐up of at least one up to 2.5 years with persistent LBB‐capture. This case series demonstrates that LBBAP following TTVI is feasible with encouraging early outcomes. Careful patient selection and dedicated follow‐up are essential for patients with CIED treated with TTVI.
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Seiler et al. (2026) conducted an observational in Transcatheter tricuspid valve implantation (TTVI) with preexisting CIED or new-onset postoperative atrioventricular block (n=36). Left bundle branch area pacing (LBBAP) and management of jailed leads after TTVI was evaluated on Feasibility of LBBAP and lead stability after TTVI. Left bundle branch area pacing after TTVI was successfully implanted in 4 patients with stable device and valve function for up to 2.5 years, and 11 patients with jailed leads had no lead failure.
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