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A review on the impact of cardiac pacing on right ventricular and tricuspid valve function
Alphonsus Liew1,2, Nadeev Wijesuriya1, Sandra Howell1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Introduction:
Conventional transtricuspid pacing including right ventricular pacing (RVP), cardiac resynchronization therapy (CRT), and implantable cardiac defibrillator (ICD) constitute the mainstay of device therapy for various indications relating to cardiac arrhythmia. However, devices with transtricuspid leads have been associated with tricuspid regurgitation (TR) progression which may exacerbate or lead to right ventricular dysfunction (RVD). Meanwhile, the impact of newer pacing modalities such as leadless pacing and conduction system pacing on TR progression and RVD is not well defined.
Areas Covered:
In this review article, we aim to summarize the risk and management of TR progression and RVD associated with different contemporary pacing modalities.
Expert Opinion:
We will provide practical recommendations for the pacing modality of choice in different settings to reduce the risk of TR progression and/or RVD. We will comment on the promising developments in cardiac pacing to reduce the risk of RVD and TR progression including leadless physiological pacing and right ventricular CRT.
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