Valvular & structural heart disease
Device-lead abnormalities and function after transcatheter tricuspid valve replacement
Authors' conclusion
Transcatheter tricuspid valve replacement with the EVOQUE system in the setting of cardiac device leads is associated with lead function changes in 31%. The majority of lead-related changes were managed conservatively, but 13% of patients had findings concerning for an insulation breach.
Study context
- Population
- Patients with pre-existing cardiac implantable electronic devices undergoing transcatheter tricuspid valve replacement (TTVR) with the EVOQUE system, Mayo Clinic Rochester
- Participants
- 32 consecutive patients
- Outcome
- CIED lead function changes (pacing thresholds, sensing, impedance)
- Follow-up
- Median device 210 days (IQR: 43-307 days)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Lead function changes after TTVR
TTVR
31%
10 of 32
- RV lead primarily affected; one case involving an atrial lead
- 1
- R-wave sensing changes, most common lead change
- 55%
- Isolated R-wave sensing alterations, managed conservatively without reprogramming
- 67%
- Ottawa score did not reliably predict lead abnormality
- P = 0.86
- Anatomical lead position did not reliably predict lead abnormality
- P = 0.53
Observational data: associations, not effects.
Further findings
Gradual impedance decline (follow-up >600 days) · follow-up exceeding 600 days
- Statistically significant gradual decline in impedance without other lead dysfunction, in 2 of 5 patients
- Suggesting potential subclinical lead degradation
Safety
Findings concerning for lead insulation breach
- Findings concerning for a lead insulation breach
- 4 (13%)
- Lead revision required
- 1 (3%)
Original publication
Device-lead abnormalities and function after transcatheter tricuspid valve replacement. Europace. Published 16 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it