TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT

Objective: To assess prospectively the presence and degree of tricuspid regurgitation (TR) after right ventricular (RV) lead placement utilizing 2-dimensional and doppler echocardiography in a group of patients implanted with Permanent pace-maker or implantable cardioverter defibrillator (ICD). S...

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Autores principales:	Muhammad Asad, Qurban Hussain Khan, Azmat Hayat, Waheed -ur- Rehman, Muhammad Shabbir, Amer Naseem, Noor Shah, Rehana Khadim
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2020
Materias:	permanent pacemaker tricuspid regurgitation implantable cardioverter defibrillators Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/c11811ad31db4e029246ec63814c3fb1
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spelling	oai:doaj.org-article:c11811ad31db4e029246ec63814c3fb12021-12-02T19:12:13ZTRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENTdoi.org/10.51253/pafmj.v70iSuppl-4.60070030-96482411-8842https://doaj.org/article/c11811ad31db4e029246ec63814c3fb12020-12-01T00:00:00Zhttps://pafmj.org/index.php/PAFMJ/article/view/6007https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To assess prospectively the presence and degree of tricuspid regurgitation (TR) after right ventricular (RV) lead placement utilizing 2-dimensional and doppler echocardiography in a group of patients implanted with Permanent pace-maker or implantable cardioverter defibrillator (ICD). Study Design: Descriptive cross sectional study. Place and Duration of Study: Study was conducted at OPD of AFIC/NIHD Rawalpindi from Jan to Jun 2019. Methodology: One hundred patients after cardiac stimulation system implantation were included in this study. Patients with severe valve disease, heart failure, congenital heart disease, pre-existing pulmonary hypertension and presence of moderate or severe tricuspid regurgitation were excluded. M-mode, 2 –dimensional and doppler echocardiographic studies were performed. Continuous-wave doppler measurements were made from apical four-chamber view in order to obtain maximum tricuspid flow velocities. A complete echocardiographic study was performed following device implantation. Echocardiographic measurements were repeated at 6-months of follow-up period. Those patients who developed tricuspid regurgitation were further assessed by color doppler, taking into account density and contour of the jet on continuous-wave doppler. Tricuspid regurgitation severity was classified into three groups: mild, moderate and severe according to the recommendations for non-invasive evaluation of native valvular regurgitation by the American Society of Echocardiography. The collected data was analysed by using SPSS-23. Results: Out of 100 patients, 67 (67%) were males and 33(33%) were females with the mean age of 65.29 ± 12.02 years. All the patients had normal chambers dimensions before the procedure. 65 (65%) had leads screwed to RV apex while 35 (35%) had through RV septum. 83 (83%) patients received a dual chamber device, while 17 (17%) patients got single chamber (ventricular) device implanted. Following device implantation after 6 months mild TR was noted in 4 (4%), moderate TR in 4 (4%) and severe TR 2 (2%) in cases. Conclusion: Tricuspid incompetence following endocardial leads implantation is not rare and occurred in approximately 10% of our patients. This complication may be preventable, because it is likely due to the interference of the endocardial lead with the TV.Muhammad AsadQurban Hussain KhanAzmat HayatWaheed -ur- RehmanMuhammad ShabbirAmer NaseemNoor ShahRehana KhadimArmy Medical College Rawalpindiarticlepermanent pacemakertricuspid regurgitationimplantable cardioverter defibrillatorsMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 70, Iss 4, Pp 721-725 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	permanent pacemaker tricuspid regurgitation implantable cardioverter defibrillators Medicine R Medicine (General) R5-920
spellingShingle	permanent pacemaker tricuspid regurgitation implantable cardioverter defibrillators Medicine R Medicine (General) R5-920 Muhammad Asad Qurban Hussain Khan Azmat Hayat Waheed -ur- Rehman Muhammad Shabbir Amer Naseem Noor Shah Rehana Khadim TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
description	Objective: To assess prospectively the presence and degree of tricuspid regurgitation (TR) after right ventricular (RV) lead placement utilizing 2-dimensional and doppler echocardiography in a group of patients implanted with Permanent pace-maker or implantable cardioverter defibrillator (ICD). Study Design: Descriptive cross sectional study. Place and Duration of Study: Study was conducted at OPD of AFIC/NIHD Rawalpindi from Jan to Jun 2019. Methodology: One hundred patients after cardiac stimulation system implantation were included in this study. Patients with severe valve disease, heart failure, congenital heart disease, pre-existing pulmonary hypertension and presence of moderate or severe tricuspid regurgitation were excluded. M-mode, 2 –dimensional and doppler echocardiographic studies were performed. Continuous-wave doppler measurements were made from apical four-chamber view in order to obtain maximum tricuspid flow velocities. A complete echocardiographic study was performed following device implantation. Echocardiographic measurements were repeated at 6-months of follow-up period. Those patients who developed tricuspid regurgitation were further assessed by color doppler, taking into account density and contour of the jet on continuous-wave doppler. Tricuspid regurgitation severity was classified into three groups: mild, moderate and severe according to the recommendations for non-invasive evaluation of native valvular regurgitation by the American Society of Echocardiography. The collected data was analysed by using SPSS-23. Results: Out of 100 patients, 67 (67%) were males and 33(33%) were females with the mean age of 65.29 ± 12.02 years. All the patients had normal chambers dimensions before the procedure. 65 (65%) had leads screwed to RV apex while 35 (35%) had through RV septum. 83 (83%) patients received a dual chamber device, while 17 (17%) patients got single chamber (ventricular) device implanted. Following device implantation after 6 months mild TR was noted in 4 (4%), moderate TR in 4 (4%) and severe TR 2 (2%) in cases. Conclusion: Tricuspid incompetence following endocardial leads implantation is not rare and occurred in approximately 10% of our patients. This complication may be preventable, because it is likely due to the interference of the endocardial lead with the TV.
format	article
author	Muhammad Asad Qurban Hussain Khan Azmat Hayat Waheed -ur- Rehman Muhammad Shabbir Amer Naseem Noor Shah Rehana Khadim
author_facet	Muhammad Asad Qurban Hussain Khan Azmat Hayat Waheed -ur- Rehman Muhammad Shabbir Amer Naseem Noor Shah Rehana Khadim
author_sort	Muhammad Asad
title	TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
title_short	TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
title_full	TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
title_fullStr	TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
title_full_unstemmed	TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT
title_sort	tricuspid valve regurgitation in patients undergoing endocardial leads placement
publisher	Army Medical College Rawalpindi
publishDate	2020
url	https://doaj.org/article/c11811ad31db4e029246ec63814c3fb1
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TRICUSPID VALVE REGURGITATION IN PATIENTS UNDERGOING ENDOCARDIAL LEADS PLACEMENT

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