ArticleJournal of clinical medicine2023
Identification of Pacemaker Lead Position Using Fluoroscopy to Avoid Significant Tricuspid Regurgitation.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Explainable Lightweight AI for the Identification of Right-Sided Cardiac Dysfunction in a Saudi Arabian Diabetic Cohort.Journal of clinical medicine · 2026Article
- The Two-Device Problem: A Comprehensive Framework for Managing Transvalvular CIED Leads in the Era of Transcatheter Tricuspid Intervention.Journal of clinical medicine · 2026Review
- When Patent Foramen Ovale (PFO) Can Cause Trouble-A Misplacement of Pacemaker Lead Into the Left Ventricle.Case reports in cardiology · 2026Article
- High-resolution 3D visualization of human hearts with emphases on the cardiac conduction system components-a new platform for medical education, mix/virtual reality, computational simulation.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Permanent pacemaker implantation improves survival but can cause tricuspid valve dysfunction in the form of tricuspid regurgitation (TR). The dominant mechanism of pacemaker-mediated TR is lead impingement. This study evaluated the association between the location of the pacemaker leads crossing the tricuspid valve and the incidence of worsening TR and lead impingement using fluoroscopy. Lead positions were evaluated using perpendicular right anterior oblique (RAO) and parallel left anterior oblique (LAO) fluoroscopic angulation views of the tricuspid annulus. A two-dimensional transthoracic echocardiogram (TTE) was performed to evaluate the maximum TR jet area-to-right atrium ratio and define regurgitation severity. A three-dimensional TTE was performed to evaluate lead impingement. A worsening of TR was observed in 23 of 82 subjects. Most leads had an inferior position in the RAO view and a septal position in the LAO view. The mid position in the RAO view and septal position in the LAO view were risk factors for lead impingement. Mid and septal positions were associated with higher risks of significant TR and lead impingement. Lead impingement was associated with a high risk of significant TR. Pacemaker-mediated TR remains a significant problem after lead implantation.
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