期刊
HEART RHYTHM
卷 15, 期 7, 页码 1009-1016出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2018.02.026
关键词
Echocardiography; Implantable cardioverter-defibrillator; Left ventricular pacing; Pacing lead; Tricuspid regurgitation
资金
- St. Jude Medical Foundation
BACKGROUND Pacing lead-related tricuspid regurgitation (TR), a recognized complication of ventricular pacing lead implantation, may be affected by lead position or diameter. OBJECTIVE This study sought to determine the effect of ventricular pacing lead position and diameter on pacing lead-related TR. METHODS A randomized prospective trial compared pacing leads in the right ventricular apex (RVA), right ventricular septum (RVS), or left ventricle via the coronary sinus (LV-CS) in a 1:1:1 fashion. Patients undergoing implantable cardioverter-defibrillator lead implantation in the RVA (RVA-ICD) were enrolled in a comparison group. Patients with preexisting moderate or greater TR were excluded. Prospective clinical evaluation, transthoracic echocardiograms, and device interrogation occurred 24 hours and 12 months after device implantation. RESULTS Sixty-three patients undergoing pacemaker implantation were randomized to RVA, RVS, or LV-CS pacing, and 48 RVA-ICD patients were enrolled as a comparison group. At 12 months, 6 patients (6.4%) developed moderate or greater TR. Moderate or greater TR was not significantly different between groups if analyzed by intention to treat (RVA 5.9%, RVS 10.0%, LV-CS 6.7%, and RVA-ICD 4.8%) or if analyzed by final lead location (RVA 4.8%, RVS 10.5%, LV-CS 8.3%, and RVA-ICD 5.1%). Ventricular lead-related complications occurred in 3 patients with right ventricular leads (3.2%) and 2 patients with LV-CS leads (11.1%) (P = .184). CONCLUSION Neither pacing lead position nor diameter appears to affect TR development significantly. LV-CS leads failed to achieve a statistically significant reduction in TR as compared with right ventricular leads.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据