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Insights of tricuspid regurgitation mechanisms in patients with right ventricular apical pacing by three-dimensional echocardiography.
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  • Diego Chango,
  • Martín Munín,
  • Gustavo Sánchez,
  • Ignacio Raggio,
  • María Eugenia Pelayo,
  • Hugo Garro,
  • Mario Arévalo,
  • Justo Carbajales,
  • Silvia Makhoul,
  • Ricardo Ronderos
Diego Chango
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno

Corresponding Author:diegochangomd@gmail.com

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Martín Munín
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno
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Gustavo Sánchez
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno
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Ignacio Raggio
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno
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María Eugenia Pelayo
Hospital General de Agudos Jose Maria Ramos Mejia
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Hugo Garro
Hospital General de Agudos Jose Maria Ramos Mejia
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Mario Arévalo
Hospital General de Agudos Jose Maria Ramos Mejia
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Justo Carbajales
Hospital General de Agudos Jose Maria Ramos Mejia
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Silvia Makhoul
Hospital General de Agudos Juan A Fernandez
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Ricardo Ronderos
Universidad Nacional de la Plata
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Abstract

Objective: Device lead-induced tricuspid regurgitation (LITR) mechanisms are well-defined by 3D transthoracic echocardiography (3D-TTE). There is a lack of data on the Latin-American population. The objective of this study was to describe the prevalence of several mechanisms and insights in patients with permanent right ventricular (RV) implanted devices by 3D-TTE examination. Methods: We performed a cross-sectional analysis of 101 patients with permanent cardiac devices such as pacemakers or defibrillators. 3D-TTE was obtained on all patients in RV-focused apical views to perform a complete tricuspid valve (TV) evaluation: leaflets, subvalvular apparatus, precise lead location, and functional assessment to evaluate possible mechanisms of tricuspid regurgitation (TR). Results: In a total of 101 patients, the leads did not interfere with TV function in 53 p. (59%), while LITR was observed in 38 (41%) patients. Adherent, impinging, entangled, and mixed lead-induced mechanisms were observed. Time in years since device implantation was significantly higher in patients with LITR. Conclusions: LITR was present in a high proportion of our population. LITR is the result of damage to the TV as well as its subvalvular apparatus due to the fibrotic and inflammatory response over time when leads are situated in unfavorable locations.
27 Feb 2023Submitted to Echocardiography
13 Mar 2023Submission Checks Completed
13 Mar 2023Assigned to Editor
19 Mar 2023Reviewer(s) Assigned
06 Apr 2023Review(s) Completed, Editorial Evaluation Pending
06 Apr 2023Editorial Decision: Revise Major
24 May 20231st Revision Received
20 Jun 2023Submission Checks Completed
20 Jun 2023Assigned to Editor
20 Jun 2023Reviewer(s) Assigned
04 Jul 2023Review(s) Completed, Editorial Evaluation Pending
06 Jul 2023Editorial Decision: Accept