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Permanent cardiac pacing and its influence on tricuspid valve function
W Krupa1, D Kozłowski, P Derejko
1II Department of Cardiology, Medical University of Gdańsk, ul. Kieturakisa 1, 80-742 Gdańsk, Poland. wkrupa@amg.gda.pl
Folia Morphologica
|January 5, 2002
Summary
This study found that the placement of pacing leads near the tricuspid valve does not significantly affect tricuspid regurgitation. Lead positioning in the right ventricle is common, but doesn't correlate with valve insufficiency.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Transvenous device implantation is common in cardiology.
- Lead placement can cause fibrosis and tricuspid regurgitation.
- Electrode position in the tricuspid orifice may impact leaflet function.
Purpose of the Study:
- To detail lead topography in the right ventricle using echocardiography.
- To compare lead location with tricuspid valve function.
- To investigate the relationship between lead placement and tricuspid insufficiency.
Main Methods:
- Echocardiography in 86 patients with pacemakers or ICDs.
- Assessed lead position relative to tricuspid valve leaflets and commissures.
- Categorized lead tip position (apex, outflow tract, para-apex).
- Evaluated tricuspid regurgitation using Color-flow Doppler.
Main Results:
- Leads contacted anterior (35%), septal (23%), or posterior (12%) leaflets.
- 10% of leads were between leaflets; 20% centrally located.
- Most leads ran centrally (45%) or along the septum (39%).
- Lead tip was apical in 74%, outflow tract in 9%, para-apical in 17%.
- No significant difference in tricuspid regurgitation based on lead topography.
Conclusions:
- Leads are often in the anteroseptal annulus with apical tip placement (approx. 75%).
- Electrode location at the tricuspid orifice does not influence insufficiency.
- Echocardiographic assessment of lead topography is crucial for understanding device impact.