Valvular & structural heart diseaseMeta-analysis
Evolution and prognosis of tricuspid and mitral regurgitation following cardiac implantable electronic devices: a systematic review and meta-analysis
- Systematic review and meta-analysis
Searched PubMed, EMBASE and Cochrane Library until 31 October 2023
Authors' conclusion
Our findings suggest that, when possible, adoption of pacing strategies that avoid isolated trans-tricuspid RV leads may be beneficial in preventing incident or deteriorating atrioventricular valvular regurgitation and might reduce mortality.
Study context
- Population
- Patients with cardiac implantable electronic devices (CIEDs)57 tricuspid regurgitation (TR) studies, n = 13,723
- Comparison
- Pacing strategies and post-CIED TR and mitral regurgitation (MR)
- Outcome
- Significant (≥ moderate) post-CIED TR and MR
Pooled result
As reported in the abstract
Significant post-CIED TR and MR
Odds ratio (95% CI)
All CIEDTR, after 12 months median follow-up
2.46(1.88–3.22)
All CIEDMR, after 6 months median follow-up
0.74(0.58–0.94)
RVPTR
4.54(3.14–6.57)
RVPMR
2.24(1.18–4.26)
CSPTR, not altered
0.37(0.13–1.02)
CSPMR, significantly reduced
0.15(0.03–0.62)
CRTTR, not significant
1.09(0.55–2.17)
CRTMR prevalence 43% pre-CRT to 22% post-CRT
0.49(0.40–0.61)
LPTR, not significant
1.15(0.83–1.59)
LPMR, not significant
1.31(0.72–2.39)
Further pooled results
All-cause mortality with CIED-associated TR (prognosis) · median of 53 months
| Comparison | pooled HR (95% CI) | |
|---|---|---|
| Cardiac implantable electronic device-associated TR · independently predictive | 1.64 (1.40–1.90) | |
| 0.512Pooled hazard ratio (log scale) |
All-cause mortality with MR persisting post-CRT (prognosis) · 38 months
| Comparison | HR (95% CI) | |
|---|---|---|
| Mitral regurgitation persisting post-CRT · independently predicted | 2.00 (1.57–2.55) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Evolution and prognosis of tricuspid and mitral regurgitation following cardiac implantable electronic devices: a systematic review and meta-analysis. Europace. Published 30 May 2024. doi:10.1093/europace/euae143
Summarised from the published abstract; every number is checked against it