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Updated: Sep 9, 2025
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Effects of Electrode Thickness on Tricuspid Regurgitation and Radiation Exposure in Single-Chamber Implantable
Fatih Gülçebi1, Ahmet Özderya1, İsmet Durmuş2
1Department of Cardiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
Background:
Currently, cardiac devices are widely used, and the effects of the electrodes of these devices on the tricuspid valve are being investigated. This study aimed to prospectively investigate, using two-dimensional echocardiography, the impact of electrode thickness on the development of tricuspid regurgitation (TR) and operator radiation exposure during the implantation of single-chamber implantable cardioverter-defibrillators (VVI-ICDs).
Methods:
This prospective study included 61 patients treated at a single center between March 2023 and January 2024. Among these, 31 patients received 9F electrodes, and 30 patients received 7F electrodes. Initial echocardiographic evaluation was conducted 1 day before device implantation (T0). Follow-up evaluations were performed 1 day (T1) and 1 month (T2) after implantation. Tricuspid regurgitation was assessed using two-dimensional (2D) echocardiography and classified into grades 1-4 based on vena contracta and proximal isovelocity surface area measurements. A worsening of TR by one grade or more was deemed significant. Electrode implantation times and radiation doses were recorded during the procedures. At the 1-month follow-up, device interrogation was performed, and pacing percentages were documented.
Results:
Baseline echocardiographic parameters were comparable between the two groups. No significant TR worsening was observed at T1 in either group (p = 1.00). At T2, TR worsening was significantly more prevalent in the 9F group (p = 0.033). However, the 7F group demonstrated significantly longer electrode implantation times (p = 0.014) and higher total radiation exposure (p = 0.011). No deterioration in right heart function was observed in either group during the 1-month follow-up.
Conclusions:
The use of thinner electrodes in VVI-ICD implantation may reduce electrode-related TR worsening. However, thinner electrodes are more challenging to implant, resulting in prolonged procedure times and increased radiation exposure for the operator. Further large-scale prospective studies are needed to confirm these findings.
