Key result
Saline infusion resolves post-TriClip postural ventricular arrhythmias in a case report.
Why the study?
Electrical complications from device-tissue interactions after transcatheter edge-to-edge repair for severe tricuspid regurgitation remain poorly characterized, particularly regarding how orthostatic volume shifts trigger device-related complications.
Case Report (n=1)
This first reported case demonstrates that orthostatic volume shifts can provoke dynamic device-tissue contact and postural ventricular arrhythmias after tricuspid transcatheter edge-to-edge repair, which may be successfully managed conservatively with volume expansion.
Answers are grounded in this paper and cite their sources.
Consider orthostatic volume shifts in post-tricuspid TEER arrhythmias; hypothesis-generating for dynamic clip-tissue contact.
BACKGROUND: Transcatheter edge-to-edge repair (TEER) treats severe tricuspid regurgitation, but electrical complications from device-tissue interactions remain poorly characterized. CASE SUMMARY: A 79-year-old woman developed postural ventricular arrhythmias after TriClip implantation. Electrocardiography was consistent with an ectopic origin in the posterior/inferior right ventricle, anatomically concordant with the posteroseptal clip. Orthostatic reduction in right ventricular volume may have induced dynamic clip-endocardium contact. Saline infusion abolished the arrhythmias. At 1 month, she remained asymptomatic despite unchanged device-to-septum distance on supine echocardiography, suggesting stabilization of the device-tissue interface over time. DISCUSSION: As the first reported case of postural arrhythmia from mechanical TriClip-septal interaction, this addresses a gap in TEER literature regarding how orthostatic volume shifts trigger device-related complications. TAKE-HOME MESSAGES: Orthostatic volume shifts may provoke dynamic device-tissue contact and arrhythmias post-TEER. Careful clip positioning and vigilant postprocedural monitoring are essential, and stabilization of the device-tissue interface over time may allow conservative management.
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Phangmuangdee et al. (2026) conducted a case report in Postural ventricular arrhythmias after transcatheter edge-to-edge tricuspid valve repair (n=1). Transcatheter edge-to-edge repair (TriClip) and saline infusion was evaluated on Resolution of postural ventricular arrhythmias. Saline infusion abolished postural ventricular arrhythmias in a 79-year-old woman after TriClip implantation, with the patient remaining asymptomatic at 1 month.
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