Valvular & structural heart diseaseCohort study
Alternative pacing strategies after transcatheter tricuspid valve interventions: Procedural challenges and lessons learned
- retrospective
- single institution
- consecutive patients
Authors' conclusion
Alternative nontransvalvular pacing strategies may be feasible and safe in patients who require pacing after TTVI. Preprocedural planning with a multidisciplinary approach can help optimize procedural success. Further studies and longer-term follow-up are warranted.
Study context
- Population
- Patients undergoing transcatheter tricuspid valve intervention (TTVI), including transcatheter edge-to-edge repair (TEER) or transcatheter tricuspid valve replacement (TTVR), evaluated for new pacemaker indications and pacing strategypatients who underwent TTVI, 34 (25%) excluded for preexisting pacemaker, 15 of 103 (15%) developed a pacing indication · TTVR 69 · TEER 68
- Participants
- 137 patients
- Exposure
- Nontransvalvular pacing strategies after TTVI
- TEERn = 68
- TTVRn = 69
Main finding
As reported in the abstract
Indication for pacing after TTVI
- Patients without preexisting pacemaker who developed a pacing indication
- 15 of 103 patients (15%)
Observational data: associations, not effects.
Further findings
- Success of alternative pacing strategy after TEER · initial attempt
- 50% successful (2 of 4) · coronary sinus (CS) lead placement · leadless pacemaker (LP) attempt unsuccessful (0 of 1)
- Success of alternative pacing strategy after TTVR · initial attempt
- 75% successful (6 of 8) · CS lead placement · LP placement 100% successful (2 of 2)
Procedural limitations
- CS lead placement was limited by CS anatomy, whereas LP placement was limited by TTVR interaction
- A transvenous pacemaker was successfully placed if needed
Safety
Pacemaker device-related adverse events · peri-procedurally or at 1-year follow-up
- No pacemaker device-related adverse event occurred in any patient
Original publication
Alternative pacing strategies after transcatheter tricuspid valve interventions: Procedural challenges and lessons learned. Heart Rhythm. Published 10 October 2025. doi:10.1016/j.hrthm.2025.10.013
Summarised from the published abstract; every number is checked against it