PMID: 11915988Mar 28, 2002Paper

The challenge of endocardial right ventricular pacing in patients with a tricuspid annuloplasty ring and severe tricuspid regurgitation

Pacing and Clinical Electrophysiology : PACE
Peter M KistlerH Mond

Abstract

On occasion, patients with a tricuspid annuloplasty ring may require permanent cardiac pacing. Although it is technically possible to pass a ventricular transvenous lead through a tricuspid valve with an annuloplasty ring, the procedure is complicated by considerable chamber enlargement and mechanical distortion of the tricuspid valve often with severe residual tricuspid regurgitation. Over a 25-month period, transvenous ventricular lead placement following insertion of a tricuspid annuloplasty ring was successfully performed in five patients (three women). The patient mean age was 66 years (range 55-77 years). Four cases had slow atrial fibrillation and another paroxysmal atrial fibrillation requiring His-bundle ablation. Two patients had mitral valve replacement and two aortic and mitral valve replacements. All patients had residual severe to torrential tricuspid regurgitation. Seven ventricular steroid-eluting screw-in leads were used. Single leads were used in three cases, whereas in two others, two ventricular leads were attached to a dual chamber pulse generator. Although technically difficult, ventricular lead placement was successful using standard guidewires with broad curvatures. Satisfactory acute and follow-up stimu...Continue Reading

Citations

Nov 24, 2012·Journal of Cardiac Surgery·Robert C Neely, Henry M Spotnitz
Apr 3, 2019·Journal of Cardiovascular Electrophysiology·Florian E M HerrmannGerd Juchem
Jan 19, 2021·International Heart Journal·Florian Ernst Martin HerrmannGerd Juchem

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