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Device-lead abnormalities and function after transcatheter tricuspid valve replacement.

Muhannad Abbasi1, Ammar M Killu1, Christoff Van Niekerk2

  • 1Department of Cardiovascular Medicine, Mayo Clinic Rochester, 200 1st ST SW, Rochester, MN 55902, USA.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|October 16, 2025
PubMed
Summary
This summary is machine-generated.

Transcatheter tricuspid valve replacement (TTVR) can affect cardiac implantable electronic device (CIED) leads in 31% of patients. Most lead changes were minor and managed conservatively, but some required intervention.

Keywords:
Cardiac implantable electronic devicesEVOQUE valve systemLead dysfunctionTranscatheter tricuspid valve replacementTricuspid valve jailing

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Transcatheter tricuspid valve replacement (TTVR) is increasingly used for severe tricuspid regurgitation.
  • Patients undergoing TTVR often have pre-existing cardiac implantable electronic devices (CIEDs).
  • The impact of TTVR on CIED integrity and function remains incompletely understood.

Purpose of the Study:

  • To evaluate the effect of TTVR using the EVOQUE valve system on CIED lead function.
  • To assess changes in pacing thresholds, sensing, and impedance post-TTVR.
  • To identify potential complications related to CIED leads during TTVR.

Main Methods:

  • Retrospective observational study at Mayo Clinic Rochester.
  • Inclusion of 32 consecutive patients with pre-existing CIEDs undergoing TTVR with the EVOQUE system.
  • Analysis of CIED lead parameters (pacing thresholds, sensing, impedance) before and after TTVR.

Main Results:

  • 31% of patients (10/32) experienced lead function changes post-TTVR.
  • Right ventricular leads were most commonly affected.
  • R-wave sensing changes were the most frequent alteration (55% of affected cases), often isolated and managed conservatively.
  • 13% of patients (4/32) showed concerning findings for lead insulation breach, with one requiring lead revision.
  • Two patients (40% of those with >600 days follow-up) showed gradual impedance decline, suggesting potential subclinical lead degradation.

Conclusions:

  • TTVR with the EVOQUE system is associated with lead function changes in 31% of patients with CIEDs.
  • Most lead-related changes are manageable conservatively, but a subset requires intervention due to insulation breach concerns.
  • Further research is needed to optimize implantation techniques and management strategies for device-lead interactions during TTVR.