Cardiac device implantation was associated with worsening tricuspid regurgitation in 61.7% of patients at 6 months, predicted by multiple leads (p=0.01) and apical lead position (p=0.03).
Cohort (n=60)
No
Does cardiac implantable electronic device (CIED) implantation cause new or worsened tricuspid regurgitation in patients undergoing device implantation?
CIED implantation is associated with a high incidence (61.7%) of worsening tricuspid regurgitation at 6 months, particularly in patients with multiple leads, apical lead positioning, or pre-existing diastolic dysfunction.
Abstract Introduction Tricuspid regurgitation (TR), long regarded as a secondary and benign valve disorder, is now recognized as an important prognostic marker, particularly in patients with heart failure. Among acquired causes, cardiac implantable electronic devices (CIEDs) have emerged as a significant contributor to TR progression. Objective To assess the incidence and predictors of new or worsened TR following CIED implantation. Methods This prospective single-center study included all patients who underwent device implantation between June 2024 and March 2025. Transthoracic echocardiography was performed before implantation and repeated at 6 months to evaluate TR severity. Results Sixty patients were included (mean age 75 ± 10 years, sex ratio 0.49). Implanted devices consisted of 22 single-chamber pacemakers (36.7%), 36 dual-chamber pacemakers (60%), one CRT device (1.7%), and one ICD (1.7%). Right ventricular lead position was apical in 70% and septal in 30%. No patient had more than moderate TR at baseline. No complications occurred during implantation or immediately thereafter. At 6 months, 61.7% of patients demonstrated worsening TR. Significant predictors of TR progression included: • presence of multiple leads (p = 0.01), • apical right ventricular lead position (p = 0.03), • impaired left ventricular diastolic function prior to implantation. Conclusion CIED implantation is associated with a substantial risk of TR aggravation. Multiple leads, apical lead positioning, and pre-existing diastolic dysfunction are key predictors of worsening TR. These findings underscore the importance of optimal lead placement and routine echocardiographic surveillance in patients receiving cardiac devices.
Allouche et al. (Mon,) conducted a cohort in Tricuspid regurgitation (n=60). Cardiac implantable electronic device (CIED) implantation was evaluated on Worsening tricuspid regurgitation at 6 months. Cardiac device implantation was associated with worsening tricuspid regurgitation in 61.7% of patients at 6 months, predicted by multiple leads (p=0.01) and apical lead position (p=0.03).