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Improvement in lead-related tricuspid regurgitation after transvenous lead extraction: A prospective multicenter
Mouhannad Sadek1, Yaariv Khaykin1, Mehrdad Golian2
1Department of Cardiac Health, Southlake Health, Newmarket, Canada; University of Toronto, Canada.
Heart Rhythm
|July 14, 2026
Summary
Transvenous lead extraction (TLE) can improve severe tricuspid regurgitation (TR) caused by cardiac implantable electronic device (CIED) leads. Shorter lead dwell times predict better TR recovery after TLE.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Electrophysiology
Background:
- Cardiac implantable electronic device (CIED) leads can cause or worsen tricuspid regurgitation (TR) due to mechanical leaflet impingement.
- The impact of transvenous lead extraction (TLE) on TR severity is not well understood.
Purpose of the Study:
- To assess TR severity changes after TLE in patients with severe, lead-related TR.
- To identify predictors of TR improvement following TLE.
Main Methods:
- Prospective, multicenter registry of 25 patients with severe TR and CIED lead impingement.
- Patients underwent TLE, with TR severity evaluated by echocardiography before and after the procedure.
Main Results:
- 36% of patients (9/25) showed improved TR severity post-TLE.
- TR improvement was observed within 3-4 months and progressed over the first year.
- Shorter lead dwell times were significantly associated with TR improvement (2.6 vs. 8.2 years, p=0.025).
Conclusions:
- Over one-third of patients experienced meaningful TR improvement after TLE.
- Shorter lead dwell time is a predictor of TR recovery, suggesting early intervention is beneficial.
- Timely TLE should be considered for selected patients with lead-related TR.
Keywords:
Cardiac device complicationsCardiac implantable electronic deviceDevice-related valvular diseaseLead impingementLead-related tricuspid regurgitationTransvenous lead extractionTricuspid regurgitationMore Related Videos
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