Tricuspid Right Ventricular Lead Entrapment in Transcatheter Tricuspid Interventions: The Tri-LEAD Study

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Tricuspid transcatheter edge-to-edge repair (T-TEER) effectively treats severe tricuspid regurgitation.
• Preexisting right ventricular (RV) pacing leads may experience dysfunction following T-TEER.

Purpose of the Study:

• To assess the 2-year safety and functional outcomes of RV pacing leads after T-TEER.
• To evaluate the impact of T-TEER on RV lead performance and potential complications.

Main Methods:

• Retrospective analysis of 146 patients from the Tri-LEAD multicenter international registry (2015-2023).
• Primary outcome: RV lead dysfunction (defined by changes in function, dislodgement, or fracture) at 2 years post-T-TEER.
• Secondary outcomes included need for intervention due to lead dysfunction or cardiac complications.

Main Results:

• Over a median follow-up of 557 days, minimal changes in RV lead sensing, impedance, and threshold were observed.
• No cases of RV lead fracture, dislodgement, or cardiac perforation occurred.
• T-TEER was not associated with an increased risk of the composite safety endpoint (aSHR: 1.39; P = 0.41).

Conclusions:

• T-TEER demonstrates no detrimental short- or midterm impact on transvenous RV lead performance.
• The procedure is a safe option for patients requiring T-TEER with an indwelling RV pacing lead.