7 Citations (Scopus)

Abstract

Purpose: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation. Methods: We reviewed 148 patients (age 68 ± 15) that received a CRMD. TR and pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography before and after CRMD implantation were analyzed. Hospitalizations for CHF exacerbation post-implantation were counted. Results: Follow-up was 32 ± 14 months. Ninety-nine (67 %) patients had no change, 24 (16 %) slight, and 9 (6 %) significant increase in TR after CRMD implantation, while 13 (9 %) patients had slight and 3 (2 %) significant improvement. Patients with a significant increase in TR had higher incidence of hospitalizations (1.7 ± 0.5) compared to patients with slight (0.8 ± 1; p = 0.006) or no increase (0.5 ± 1; p = 0.0002) in TR. Patients with significant increase in TR had a greater change in PASP (25 mmHg; p = 0.002) after device implantation compared to those with a slight (10 mmHg; p = 0.002) or no increase (0.7 mmHg; p = 0.17). Conclusion: Increased TR following CRMD implantation is relatively common (33 %) and correlated with subsequent risk of hospitalization for heart failure. A preventive strategy and close monitoring for development or worsening of CHF after CRMD implantation may help prevent hospital admissions.

Original languageEnglish (US)
Pages (from-to)197-202
Number of pages6
JournalJournal of Interventional Cardiac Electrophysiology
Volume38
Issue number3
DOIs
StatePublished - Dec 1 2013

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Tricuspid Valve Insufficiency
Equipment and Supplies
Hospitalization
Heart Failure
Pulmonary Artery
Blood Pressure
Tricuspid Valve
Doppler Echocardiography
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Baquero, Giselle A. ; Yadav, Pradeep ; Skibba, Joshua B. ; Banchs, Javier E. ; Linton-Frazier, Latoya N. ; Lengerich, Eugene J. ; Samii, Soraya M. ; Penny-Peterson, Erica ; Wolbrette, Deborah L. ; Luck, Jerry C. ; Naccarelli, Gerald V. ; Gonzalez, Mario D. / Clinical significance of increased tricuspid valve incompetence following implantation of ventricular leads. In: Journal of Interventional Cardiac Electrophysiology. 2013 ; Vol. 38, No. 3. pp. 197-202.
@article{449e687fdbed4b46b3271df03b5d9443,
title = "Clinical significance of increased tricuspid valve incompetence following implantation of ventricular leads",
abstract = "Purpose: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation. Methods: We reviewed 148 patients (age 68 ± 15) that received a CRMD. TR and pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography before and after CRMD implantation were analyzed. Hospitalizations for CHF exacerbation post-implantation were counted. Results: Follow-up was 32 ± 14 months. Ninety-nine (67 {\%}) patients had no change, 24 (16 {\%}) slight, and 9 (6 {\%}) significant increase in TR after CRMD implantation, while 13 (9 {\%}) patients had slight and 3 (2 {\%}) significant improvement. Patients with a significant increase in TR had higher incidence of hospitalizations (1.7 ± 0.5) compared to patients with slight (0.8 ± 1; p = 0.006) or no increase (0.5 ± 1; p = 0.0002) in TR. Patients with significant increase in TR had a greater change in PASP (25 mmHg; p = 0.002) after device implantation compared to those with a slight (10 mmHg; p = 0.002) or no increase (0.7 mmHg; p = 0.17). Conclusion: Increased TR following CRMD implantation is relatively common (33 {\%}) and correlated with subsequent risk of hospitalization for heart failure. A preventive strategy and close monitoring for development or worsening of CHF after CRMD implantation may help prevent hospital admissions.",
author = "Baquero, {Giselle A.} and Pradeep Yadav and Skibba, {Joshua B.} and Banchs, {Javier E.} and Linton-Frazier, {Latoya N.} and Lengerich, {Eugene J.} and Samii, {Soraya M.} and Erica Penny-Peterson and Wolbrette, {Deborah L.} and Luck, {Jerry C.} and Naccarelli, {Gerald V.} and Gonzalez, {Mario D.}",
year = "2013",
month = "12",
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doi = "10.1007/s10840-013-9826-2",
language = "English (US)",
volume = "38",
pages = "197--202",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer Netherlands",
number = "3",

}

Clinical significance of increased tricuspid valve incompetence following implantation of ventricular leads. / Baquero, Giselle A.; Yadav, Pradeep; Skibba, Joshua B.; Banchs, Javier E.; Linton-Frazier, Latoya N.; Lengerich, Eugene J.; Samii, Soraya M.; Penny-Peterson, Erica; Wolbrette, Deborah L.; Luck, Jerry C.; Naccarelli, Gerald V.; Gonzalez, Mario D.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 38, No. 3, 01.12.2013, p. 197-202.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical significance of increased tricuspid valve incompetence following implantation of ventricular leads

AU - Baquero, Giselle A.

AU - Yadav, Pradeep

AU - Skibba, Joshua B.

AU - Banchs, Javier E.

AU - Linton-Frazier, Latoya N.

AU - Lengerich, Eugene J.

AU - Samii, Soraya M.

AU - Penny-Peterson, Erica

AU - Wolbrette, Deborah L.

AU - Luck, Jerry C.

AU - Naccarelli, Gerald V.

AU - Gonzalez, Mario D.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Purpose: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation. Methods: We reviewed 148 patients (age 68 ± 15) that received a CRMD. TR and pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography before and after CRMD implantation were analyzed. Hospitalizations for CHF exacerbation post-implantation were counted. Results: Follow-up was 32 ± 14 months. Ninety-nine (67 %) patients had no change, 24 (16 %) slight, and 9 (6 %) significant increase in TR after CRMD implantation, while 13 (9 %) patients had slight and 3 (2 %) significant improvement. Patients with a significant increase in TR had higher incidence of hospitalizations (1.7 ± 0.5) compared to patients with slight (0.8 ± 1; p = 0.006) or no increase (0.5 ± 1; p = 0.0002) in TR. Patients with significant increase in TR had a greater change in PASP (25 mmHg; p = 0.002) after device implantation compared to those with a slight (10 mmHg; p = 0.002) or no increase (0.7 mmHg; p = 0.17). Conclusion: Increased TR following CRMD implantation is relatively common (33 %) and correlated with subsequent risk of hospitalization for heart failure. A preventive strategy and close monitoring for development or worsening of CHF after CRMD implantation may help prevent hospital admissions.

AB - Purpose: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation. Methods: We reviewed 148 patients (age 68 ± 15) that received a CRMD. TR and pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography before and after CRMD implantation were analyzed. Hospitalizations for CHF exacerbation post-implantation were counted. Results: Follow-up was 32 ± 14 months. Ninety-nine (67 %) patients had no change, 24 (16 %) slight, and 9 (6 %) significant increase in TR after CRMD implantation, while 13 (9 %) patients had slight and 3 (2 %) significant improvement. Patients with a significant increase in TR had higher incidence of hospitalizations (1.7 ± 0.5) compared to patients with slight (0.8 ± 1; p = 0.006) or no increase (0.5 ± 1; p = 0.0002) in TR. Patients with significant increase in TR had a greater change in PASP (25 mmHg; p = 0.002) after device implantation compared to those with a slight (10 mmHg; p = 0.002) or no increase (0.7 mmHg; p = 0.17). Conclusion: Increased TR following CRMD implantation is relatively common (33 %) and correlated with subsequent risk of hospitalization for heart failure. A preventive strategy and close monitoring for development or worsening of CHF after CRMD implantation may help prevent hospital admissions.

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U2 - 10.1007/s10840-013-9826-2

DO - 10.1007/s10840-013-9826-2

M3 - Article

C2 - 24022757

AN - SCOPUS:84889086582

VL - 38

SP - 197

EP - 202

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

SN - 1383-875X

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ER -