Active RV pacing significantly increased tricuspid regurgitation severity compared to intrinsic rhythm (TR vena contracta: 0.4 vs. 0.2 cm, P<0.001; TR jet area: 4.1 vs. 2.3 cm2, P<0.001).
Observational (n=23)
Does active right ventricular pacing increase tricuspid regurgitation grade in patients with a permanent pacemaker?
Active right ventricular pacing acutely worsens tricuspid regurgitation severity independent of mechanical valve interference by the pacemaker lead.
Absolute Event Rate: 0.4% vs 0.2%
p-value: p=<0.001
AIMS: The effect of right ventricular (RV) pacing on tricuspid regurgitation (TR) is debatable and is presumed to be related to an interference with valve closure by the electrode. The aim of the study was to determine the impact of pacing per se on TR grade. METHODS AND RESULTS: The study group included 23 clinically stable patients (13 males; mean age 78 +/- 12 years) with a permanent pacemaker at the RV apex (83% DDD mode) and normal left ventricular function. They were all non-dependent on pacing and were otherwise in sinus rhythm. None had a primary dysfunction of the tricuspid valve. TR grade and RV size were assessed in two consecutive echo studies with and without active RV pacing. Results showed that active RV pacing was associated with an increase in TR severity (TR vena contracta: 0.4 +/- 0.2 vs. 0.2 +/- 0.2 cm, P < 0.001; TR jet area: 4.1 +/- 2.3 vs. 2.3 +/- 1.8 cm(2), P < 0.001). This was also reflected in a significant decrease in the number of patients with mild TR (P = 0.003) and increase in the number with moderate regurgitation (P = 0.02). There was no change in RV areas with pacing. CONCLUSION: Active RV pacing is associated with a significant increase in TR grade. This effect is not induced by acute changes in the RV area and is unrelated to an interference with leaflet closure by the electrode.
Vaturi et al. (Thu,) conducted a observational in Permanent pacemaker at the right ventricular apex (n=23). Active RV pacing vs. Without active RV pacing (intrinsic rhythm) was evaluated on Tricuspid regurgitation severity (vena contracta in cm) (p=<0.001). Active RV pacing significantly increased tricuspid regurgitation severity compared to intrinsic rhythm (TR vena contracta: 0.4 vs. 0.2 cm, P<0.001; TR jet area: 4.1 vs. 2.3 cm2, P<0.001).