Valvular & structural heart diseaseCohort study
Device-lead abnormalities and function after transcatheter tricuspid valve replacement
- Retrospective observational study
- single-centre
- consecutive patients
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)
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:10.1093/europace/euaf219
Summarised from the published abstract; every number is checked against it