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Left Ventricular Pacing through Coronary Sinus Is Feasible and Safe for Patients with Prior Tricuspid Valve

Skevos Sideris1, Maria Drakopoulou2, George Oikonomopoulos3

  • 1Cardiology Department, Hippokration Hospital, Athens, Greece.

Pacing and Clinical Electrophysiology : PACE
|January 16, 2016
PubMed

Insights

Left ventricular pacing via the coronary sinus is a safe and effective option for patients needing pacemakers after tricuspid valve intervention. This minimally invasive approach shows stable long-term outcomes without lead complications.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Tricuspid valve intervention can lead to tricuspid regurgitation, complicating right ventricular lead implantation.
  • Left ventricular pacing via the coronary sinus (CS) is an alternative in select cases post-tricuspid valve repair or replacement.

Purpose of the Study:

  • To evaluate the long-term clinical outcomes of left ventricular pacing using CS lead implantation in patients with prior tricuspid valve intervention.

Main Methods:

  • Retrospective study of 17 consecutive patients requiring pacemaker implantation after tricuspid valve intervention.
  • All patients received ventricular rate-responsive (VVIR) devices with CS lead implantation for atrial fibrillation and symptomatic pauses.

Main Results:

  • Successful and uncomplicated device implantations with acceptable operation and fluoroscopy times.
  • Stable lead performance (sensing, threshold, impedance) at 2-year follow-up with no lead dislodgement.
  • Mean R-wave sensing: 7.5 mV, mean pacing threshold: 1.9 V/0.4 ms, mean impedance: 743.5 Ohm.

Conclusions:

  • Left ventricular pacing via CS lead is a viable and minimally invasive option for permanent pacing in patients with tricuspid valve intervention.
  • This approach offers durable lead performance and avoids risks associated with right ventricular leads in this population.
Abstract

Keywords:
coronary sinuspacingtricuspid valve prosthesis

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