Valvular & structural heart disease
Improvement in lead-related tricuspid regurgitation after transvenous lead extraction: A prospective multicenter study
Authors' conclusion
In this prospective multicenter cohort, over one-third of patients with severe, lead-related TR experienced meaningful improvement after TLE. Shorter lead dwell time was associated with a higher likelihood of recovery, suggesting that earlier intervention may increase the likelihood of reversibility when TR is caused by leaflet impingement. These findings support timely consideration of TLE in selected patients and warrant validation in larger studies.
Study context
- Population
- Patients with severe tricuspid regurgitation (TR) and echocardiographic evidence of cardiac implantable electronic device lead impingement who underwent transvenous lead extraction (TLE)
- Participants
- 25 consecutive patients
- Exposure
- TR improvement vs without improvement
- TR improvementn = 9
- Outcome
- Improvement in TR severity on follow-up echocardiography
Methodological detailsconsecutive patients, 4 institutions
- Consecutive patients
- 4 institutions
Main finding
As reported in the abstract
Patients with improvement in TR severity following TLE
9 patients
36%
Observational data: associations, not effects.
Further findings
| Outcome | TR improvement | Without improvement | P value |
|---|---|---|---|
| Lead dwell timeSignificantly shorter with TR improvement | mean 2.6 ± 1.6 years | mean 8.2 ± 6.9 years | P = 0.025 |
Baseline characteristics
- Mean age
- 65 ± 19 years
- Male
- 44%
- Pacemakers
- 68%
- Mean lead dwell time
- 5.6 ± 6.2 years
Time course of improvement
- Improvement typically began within 3-4 months and progressed during the first year of follow-up
Original publication
Summarised from the published abstract; every number is checked against it