The effects of right ventricular pacing on tricuspid regurgitation

Abstract

Objective To study the incidence of tricuspid regurgitation (TR) after right ventricular (RV) leads implantation, and to analysis the possible influence factors and mechanism. Methods A total of 147 patients were consecutively selected between January 2010 to December 2012 in First Affiliated Hospital of Dalian Medical University, with an enrolling of complete clinic and ultrasound data. Patients underwent a permanent pacemakers (PPM) , implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy pacemake (CRT-P) implantation or replacement in cardiology of Dalian Medical University first affiliated hospital. Clinical date and echocardiography date were collected for a retrospective analysis. Multi-factor logistic regression analysis was made if multiple factors included. Results Aggravated group had a larger RV diameter and left ventricular diameter, and a higher proportion of no or mild TR preoperative compared with the control group. Multi-factor analysis for aggravated group showed that the less TR preoperative (OR=0.07, 95%CI 0.01-0.64, P=0.018) , the bigger RV diameter (OR=1.167, 95%CI 1.01-1.35, P=0. 04) , the bigger left ventricular diameter (OR=1.079, 95%CI 1.01-1.15, P=0.027) , the more TR aggravating postoperative. Compared with the control group, new reflur group have lager RV diameter [ (21.50±4.60) mm vs. (19.45±3.40) mm, P=0.018] . Conclusion Preoperative TR degree might be a predictor of TR aggravating after implantation of RV leads. The preoperative RV size related to TR aggravating and new reflux, larger RV size, higher proportion of TR aggravating or new reflux. Key words: Pacemaker, artificial; Tricuspid valve insufficiency