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Polewczyk A, Jacheć W, Nowosielecka D, et al. Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis. J Clin Med. 2021;11(1)doi: 10.3390/jcm11010089.
Polewczyk, A., Jacheć, W., Nowosielecka, D., Tomaszewski, A., Brzozowski, W., Szczęśniak-Stańczyk, D., Duda, K., & Kutarski, A. (2021). Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis. Journal of clinical medicine, 11(1), . https://doi.org/10.3390/jcm11010089
Polewczyk, Anna, et al. "Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis." Journal of clinical medicine vol. 11,1 (2021). doi: https://doi.org/10.3390/jcm11010089
Polewczyk A, Jacheć W, Nowosielecka D, Tomaszewski A, Brzozowski W, Szczęśniak-Stańczyk D, Duda K, Kutarski A. Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis. J Clin Med. 2021 Dec 24;11(1). doi: 10.3390/jcm11010089. PMID: 35011829.
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J Clin Med. 2021 Dec 24;11(1). doi: 10.3390/jcm11010089.

Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis.

Journal of clinical medicine

Anna Polewczyk, Wojciech Jacheć, Dorota Nowosielecka, Andrzej Tomaszewski, Wojciech Brzozowski, Dorota Szczęśniak-Stańczyk, Krzysztof Duda, Andrzej Kutarski

Affiliations

  1. Department of Physiology, Patophysiology and Clinical Immunology, Collegium Medicum of Jan Kochanowski University, 25-369 Kielce, Poland.
  2. Department of Cardiac Surgery, ?wi?tokrzyskie Centrum of Cardiology, 25-736 Kielce, Poland.
  3. 2nd Department of Cardiology, Zabrze, Faculty of Medical Science in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland.
  4. Department of Cardiology, The Pope John Paul II Province Hospital of Zamo??, 22-400 Zamosc, Poland.
  5. Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland.
  6. Department of Cardiac Surgery, Masovian Specialistic Hospital of Radom, 26-617 Radom, Poland.

PMID: 35011829 DOI: 10.3390/jcm11010089

Abstract

BACKGROUND: Lead-related tricuspid valve dysfunction (LDTVD) has not been studied in a large population and its management remains controversial.

METHODS: An analysis of the clinical data of 2678 patients undergoing transvenous lead extraction (TLE) in years 2008-2021 was conducted, with a separate group of 119 patients with LDTVD. Potential risk factors for LDTVD, improvement in valve function, and long-term prognosis after TLE were assessed.

RESULTS: LDTVD was diagnosed in 4.44% of patients referred for lead extraction due to different reasons. The most common mechanism of LDTVD was propping upward or clamping down the leaflet by the lead (85.71%). The probability of LDTVD was higher in female sex, patients with valvular heart disease, atrial fibrillation, heart failure, large right ventricle and high pulmonary artery systolic pressure, the presence of only pacing lead, and in case of collision of the lead with tricuspid valve and adhesion of the lead to the heart structures. The prognosis of patients with LDTVD was worse, however, patients with improved valve function after TLE showed a significantly better long-term survival.

CONCLUSIONS: Lead dependent tricuspid valve dysfunction is a potentially serious condition that requires thorough diagnostics and thoughtful management. The risk factors for LDTVD are primarily related to the course of the lead and its adhesion to the heart structures. Improvement of tricuspid valve function after TLE is observed in 35.29% of patients Patients with LDTVD have a worse long-term survival, but the improvement in valve function following TLE contributes to a significant reduction in mortality.

Keywords: improvement of tricuspid valve function; lead dependent tricuspid valve dysfunction; prognosis; transvenous lead extraction

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