Evolution of tricuspid valve regurgitation after implantation of a leadless pacemaker - a single center experience, systematic review and meta-analysis.

Haeberlin, Andreas; Bartkowiak, Joanna; Brugger, Nicolas; Tanner, Hildegard; Wan, Elaine; Baldinger, Samuel H; Seiler, Jens; Madaffari, Antonio; Thalmann, Gregor; Servatius, Helge; Roten, Laurent; Noti, Fabian; Reichlin, Tobias (2022). Evolution of tricuspid valve regurgitation after implantation of a leadless pacemaker - a single center experience, systematic review and meta-analysis. Journal of cardiovascular electrophysiology, 33(7), pp. 1617-1627. Wiley-Blackwell 10.1111/jce.15565

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INTRODUCTION

Conventional transvenous pacemaker leads may interfere with the tricuspid valve leaflets, tendinous chords and papillary muscles, resulting in significant tricuspid valve regurgitation (TR). Leadless pacemakers (LLPMs) theoretically cause less mechanical interference with the tricuspid valve apparatus. However, data on TR after LLPM implantation are sparse and conflicting. Our goal was to investigate the prevalence of significant TR before and after LLPM implantation.

METHODS

Patients who received a leadless LLPM (Micra™ TPS, Medtronic, US) between 05/2016 and 05/2021 at our center were included in this observational study if they had at least a pre- and postinterventional echocardiogram (TTE). The evolution of TR severity was assessed. Following a systematic literature review on TR evolution after implantation of a LLPM, data were pooled in a random-effects meta-analysis.

RESULTS

We included 69 patients (median age 78 years [interquartile range (IQR) 72-84 years], 26% women). Follow-up duration between baseline and follow-up TTE was 11.4 months (IQR 3.5-20.1 months). At follow-up, overall TR severity was not different compared to baseline (p=0.49). Six patients (9%) had new significant TR during follow-up after LLPM implantation, whereas TR severity improved in seven patients (10%). In the systematic review, we identified seven additional articles that investigated the prevalence of significant TR after LLPM implantation. The meta-analysis based on 297 patients failed to show a difference in significant TR before and after LLPM implantation (risk ratio 1.22, 95%-CI 0.97-1.53, p=0.11).

CONCLUSION

To date, there is no substantial evidence for a significant change in TR after implantation of a LLPM. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Häberlin, Andreas David Heinrich; Bartkowiak, Joanna; Brugger, Nicolas Jacques; Tanner, Hildegard; Baldinger, Samuel Hannes; Seiler, Jens; Madaffari, Antonio; Thalmann, Gregor; Servatius, Helge Simon; Roten, Laurent; Noti, Fabian and Reichlin, Tobias Roman

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1045-3873

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Pubmed Import

Date Deposited:

27 May 2022 16:30

Last Modified:

13 Jul 2022 00:15

Publisher DOI:

10.1111/jce.15565

PubMed ID:

35614867

Uncontrolled Keywords:

Micra atrio-ventricular leadless pacemaker tricuspid regurgitation tricuspid valve

BORIS DOI:

10.48350/170292

URI:

https://boris.unibe.ch/id/eprint/170292

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