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Koev I, Ng GA, Bolger AP, Ibrahim M. Distal His bundle pacing in a patient with surgically corrected complex Ebstein anomaly and symptomatic second-degree atrioventricular block: a case report. Eur Heart J Case Rep 2023; 7:ytad531. [PMID: 38046645 PMCID: PMC10691874 DOI: 10.1093/ehjcr/ytad531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/14/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023]
Abstract
Background Ebstein's anomaly occurs when there is an apical displacement of the tricuspid valve with septal and posterior valve leaflets tethering. This condition often occurs in association with other congenital, structural, or conduction system diseases, including intracardiac shunts, valvular lesions, arrhythmias, accessory conduction pathways, and first-degree atrioventricular (AV) block. We present for the first time a case of a patient with Ebstein's anomaly who presented with second-degree Mobitz II AV block and was successfully treated with conduction system pacing (CSP) due to her young age and the likelihood of a long-term high percentage of pacing. Case summary We present a case of a 42-year-old lady with a background of complex congenital heart disease, including severe pulmonary stenosis, Ebstein anomaly, and atrial septal defect (ASD). She required complex surgical intervention, including tricuspid valve (TV) repair and subsequently replacement, ASD closure, and pulmonary balloon valvuloplasty. She presented to our hospital with symptomatic second-degree Mobitz II AV block (dizziness, shortness of breath, and exercise intolerance) and right bundle branch block (RBBB) on her baseline ECG. Her echocardiogram showed dilated right ventricle (RV) and left ventricle (LV) with low normal LV systolic function. Due to her young age and the likelihood of a long-term high percentage of RV pacing, we opted for CSP after a detailed discussion and patient consent. The distal HIS position is the preferred pacing strategy at our centre. We could not cross the TV with the standard Medtronic C315 HIS catheter, so we had to use the deflectable C304 HIS catheter. Mapping and pacing of the distal HIS bundle were achieved by Medtronic Selectsecure 3830, 69 cm lead. HIS bundle pacing led to the correction of both second-degree Mobitz II AV block and pre-existing RBBB. The implantation was uneventful, and the patient was discharged home the next day without any acute complications. Discussion Distal HIS pacing is feasible in patients with surgically treated complex Ebstein anomaly and heart block. This approach can normalize the QRS complex with a high probability of preserving or improving LV function.
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Affiliation(s)
- Ivelin Koev
- Department of Cardiovascular Sciences, University of Leicester, University Rd, Leicester LE1 7RH, UK
- Department of Cardiology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Rd, Leicester LE3 9QP, UK
| | - G Andre Ng
- Department of Cardiovascular Sciences, University of Leicester, University Rd, Leicester LE1 7RH, UK
- Department of Cardiology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Rd, Leicester LE3 9QP, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Aidan P Bolger
- Department of Cardiovascular Sciences, University of Leicester, University Rd, Leicester LE1 7RH, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
- East Midlands Congenital Heart Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Mokhtar Ibrahim
- Department of Cardiology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Rd, Leicester LE3 9QP, UK
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Bazire B, Algalarrondo V, Dreyfus J. Permanent Pacemaker Implantation After Tricuspid Valve Surgery. JACC: CASE REPORTS 2023; 13:101805. [PMID: 37077757 PMCID: PMC10107039 DOI: 10.1016/j.jaccas.2023.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 03/30/2023]
Abstract
Tricuspid valve (TV) surgery carries a high risk of atrioventricular block. In this report, we illustrate several options for managing conduction disorders after TV surgery. The choice of cardiac implantable devices must take account of several parameters such as surgical procedure, patient's rhythm and history, and etiology of TV disease. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Baptiste Bazire
- Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France
- Address for correspondence: Dr Baptiste Bazire, Cardiology Department, Centre Cardiologique du Nord, 32-36 Rue Des Moulins Gémeaux, 93200 Saint-Denis, France.
| | - Vincent Algalarrondo
- Cardiology Department, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris France
- Paris Cité University, Paris, France
| | - Julien Dreyfus
- Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France
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Ríos-Ortega JC, Sisniegas-Razón J, Robles-Velarde V, Rodríguez-Urteaga Z. Is It Possible to Place a Pacemaker Lead Through a Bileaflet Mechanical Prosthesis? INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2023; 18:190-192. [PMID: 36872582 DOI: 10.1177/15569845231158656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
We present a 64-year-old woman who underwent mitral, aortic, and tricuspid valve (TV) replacement with mechanical prostheses. Two months after TV surgery, she presented third-degree atrioventricular block. After attempting to place a pacemaker lead through the coronary sinus, it was placed through the mechanical valve in the tricuspid position as the last option. At 1 year of follow-up, the device shows no signs of dysfunction, and the prosthesis has moderate regurgitation.
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Affiliation(s)
- Josías C Ríos-Ortega
- EsSalud, National Cardiovascular Institute, Cardiovascular Surgery Department, Lima, Peru
| | - Josué Sisniegas-Razón
- EsSalud, National Cardiovascular Institute, Cardiovascular Surgery Department, Lima, Peru
| | - Víctor Robles-Velarde
- EsSalud, National Cardiovascular Institute, Cardiovascular Surgery Department, Lima, Peru
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Zhang W, Pan X, Wang C, Ma L, Li R, He B. Implantation of right ventricular endocardial pacing lead via paravalvular leak and subsequent paravalvular leak closure in a patient with mechanical tricuspid valve. HeartRhythm Case Rep 2022; 8:362-365. [PMID: 35607332 PMCID: PMC9123329 DOI: 10.1016/j.hrcr.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Weiwei Zhang
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Pan
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Wang
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lan Ma
- Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ruogu Li
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- Address reprint requests and correspondence: Dr Ruogu Li, Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Xuhui District, Shanghai, China 200030.
| | - Ben He
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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An Z, Wu J, Li SH, Chen S, Lu FL, Xu ZY, Sung HW, Li RK. Injectable conductive hydrogel can reduce pacing threshold and enhance efficacy of cardiac pacemaker. Am J Cancer Res 2021; 11:3948-3960. [PMID: 33664872 PMCID: PMC7914366 DOI: 10.7150/thno.54959] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Pacemaker implantation is currently used in patients with symptomatic bradycardia. Since a pacemaker is a lifetime therapeutic device, its energy consumption contributes to battery exhaustion, along with its voltage stimulation resulting in local fibrosis and greater resistance, which are all detrimental to patients. The possible resolution for those clinical issues is an injection of a conductive hydrogel, poly-3-amino-4-methoxybenzoic acid-gelatin (PAMB-G), to reduce the myocardial threshold voltage for pacemaker stimulation. Methods: PAMB-G is synthesized by covalently linking PAMB to gelatin, and its conductivity is measured using two-point resistivity. Rat hearts are injected with gelatin or PAMB-G, and pacing threshold is evaluated using electrocardiogram and cardiac optical mapping. Results: PAMB-G conductivity is 13 times greater than in gelatin. The ex vivo model shows that PAMB-G significantly enhances cardiac tissue stimulation. Injection of PAMB-G into the stimulating electrode location at the myocardium has a 4 times greater reduction of pacing threshold voltage, compared with electrode-only or gelatin-injected tissues. Multi-electrode array mapping reveals that the cardiac conduction velocity of PAMB-G group is significantly faster than the non- or gelatin-injection groups. PAMB-G also reduces pacing threshold voltage in an adenosine-induced atrial-ventricular block rat model. Conclusion: PAMB-G hydrogel reduces cardiac pacing threshold voltage, which is able to enhance pacemaker efficacy.
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Guo J, Li L, Xiao G, Huang X, Li Q, Wang Y, Cai B. Feasibility and stability of left bundle branch pacing in patients after prosthetic valve implantation. Clin Cardiol 2020; 43:1110-1118. [PMID: 32609400 PMCID: PMC7533988 DOI: 10.1002/clc.23413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Left bundle branch pacing (LBBP) has emerged as a promising pacing modality for preventing pacing induced cardiomyopathy in patients complicated with conduction abnormalities (CAs) after prosthetic valve (PV) implantation. OBJECTIVE The present study aimed to evaluate the safety and feasibility of LBBP in this patient population. METHODS LBBP was attempted in 20 patients complicated with atrioventricular block after PV implantation. Surface, intracardiac electrical measurements, and echocardiographic data were documented. Lead parameters and complications were routinely tracked at implantation and each follow-up visit. RESULTS LBBP was successful in 90% (18/20) participants. The paced QRS duration and the stimulus to left ventricular activation time were 106.8 ± 6.8 ms and 65.5 ± 5.4 ms, respectively. Left bundle branch (LBB) potential was recorded in 61.1% (11/18) patients who succeeded in LBBP. During the procedure, the mean unipolar myocardium capture threshold was 0.51 ± 0.15 V@0.4 ms while the unipolar bundle capture threshold was 0.84 ± 0.51 V@0.4 ms. The mean fluoroscopic exposure time and the radiation dose were 13.0 ± 9.2 min and 81.7 ± 8.3 mGy, respectively. The average follow-up period was 10.4 ± 5.9 months (range 3-23 months). Pacing parameters remained stable and no significant lead-related complications occurred during the whole observation period. CONCLUSIONS LBBP was safe and feasible in patients with PVs. Acceptable and stable pacing parameters could be expected during the procedure and the follow-ups.
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Affiliation(s)
- Jincun Guo
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Linlin Li
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Guosheng Xiao
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Xinyi Huang
- Division of Echocardiography, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Qiang Li
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Yan Wang
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
| | - Binni Cai
- Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China
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Sakrana AA, Alzubaidi SAA, Shahat AM. MDCT of unique drainage of the anterior interventricular coronary vein into the left atrium: two case reports. BJR Case Rep 2020; 6:20190062. [PMID: 32201610 PMCID: PMC7068091 DOI: 10.1259/bjrcr.20190062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 11/15/2022] Open
Abstract
Pre-procedural CT mapping of the coronary venous system is advised by the current guidelines before many interventional procedures. The published literature for variants of the coronary venous system is scarce. The variant of anterior interventricular vein (AIV) drainage into the left atrium is extremely rare. In this paper, we present multidetector CT findings of two cases of anomalous drainage of the anterior interventricular vein into the left atrium.
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Affiliation(s)
- Amal Abdelsattar Sakrana
- Madina Cardiac Center, 23411 AL Madinah Al munawwrah, Khaled Bin Al Waleed Road, Medina, Saudi Arabia
- Department of Diagnostic and Interventional radiology, Mansoura University Hospital, 35112 12 El-Gomhoreya street, Mansoura, Egypt
| | - Shadha A. Ahmed Alzubaidi
- Madina Cardiac Center, 23411 AL Madinah Al munawwrah, Khaled Bin Al Waleed Road, Medina, Saudi Arabia
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8
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Li TYW, Seow SC, Singh D, Yeo WT, Kojodjojo P, Lim TW. Left ventricular pacing in patients with preexisting tricuspid valve disease. J Arrhythm 2019; 35:836-841. [PMID: 31844475 PMCID: PMC6898538 DOI: 10.1002/joa3.12257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conventional right ventricular (RV) pacing is increasingly recognised to cause tricuspid valve (TV) injury or dysfunction, in part due to the need to pass the lead through the valve. This may be especially problematic in patients with preexisting TV disease or prior TV surgery. An alternative in this situation is to implant a left ventricular (LV) lead instead of ventricular pacing. METHODS We performed a single-center retrospective analysis of 26 patients with tricuspid valve surgery/disease who received a LV pacing lead in the coronary veins to avoid crossing the tricuspid valve, with or without a right atrial lead. A matched control population was obtained from patients receiving conventional right ventricular pacing and outcomes were compared. Main outcomes of interest were lead stability, electrical lead parameters and change in echocardiographic parameters such as left ventricular ejection fraction (LVEF) during long-term follow-up. RESULTS Successful left ventricular pacing was established in 25 out of the 26 cases with one case converted to a RV lead due to lead dislodgement. During the 2.96 ± 1.0 year follow-up, 24 of 25 (96.0%) leads were functional with stable pacing and sensing parameters, and 1 of 25 (4.0%) was extracted for due to device infection following an episode of thrombophlebitis. CONCLUSION We conclude that in patients with existing tricuspid valve disease or surgery, ventricular pacing via the coronary veins is a feasible, safe, and reliable alternative to right ventricular pacing.
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Affiliation(s)
- Tony Y. W. Li
- Department of MedicineNational University HospitalSingapore
| | - Swee Chong Seow
- National University Heart Centre, Singapore (NUHCS)National University HospitalSingapore
| | - Devinder Singh
- National University Heart Centre, Singapore (NUHCS)National University HospitalSingapore
| | - Wee Tiong Yeo
- National University Heart Centre, Singapore (NUHCS)National University HospitalSingapore
| | - Pipin Kojodjojo
- National University Heart Centre, Singapore (NUHCS)National University HospitalSingapore
| | - Toon Wei Lim
- National University Heart Centre, Singapore (NUHCS)National University HospitalSingapore
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Single- and dual-site ventricular pacing entirely through the coronary sinus for patients with prior tricuspid valve surgery. J Interv Card Electrophysiol 2019; 56:79-89. [PMID: 31432385 DOI: 10.1007/s10840-019-00599-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/16/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Transvenous right ventricular pacing has traditionally been avoided after surgical tricuspid valve repair or replacement because of possible valvular dysfunction. Epicardial pacing has been used but it requires surgical thoracotomy and has higher lead failure rates when compared to transvenous pacing. We evaluated the lead stability and clinical outcomes in patients with isolated coronary sinus (CS) lead due to relative contraindication to transvenous pacing from prior tricuspid valve (TV) surgery. METHODS We retrospectively examined a single-center cohort of 34 patients with TV disease and/or surgery who underwent permanent pacemaker implantation with a left ventricular CS lead as the only ventricular pacing lead (to avoid crossing the TV). The clinical outcome, echocardiographic data, and pacing thresholds were evaluated at follow-up. RESULTS We implanted 19 patients with a single-CS lead and 15 patients with dual-CS leads. The average left ventricular ejection fraction was 56 ± 13% prior to lead implantation and remained stable at 2-year follow-up. The tricuspid regurgitation remained mild at follow-up. The average lead pacing threshold was 1.2 ± 0.6 V × ms at implant and 1.1 ± 0.4 V × ms at 2-year follow-up (P = 0.39). For patients with dual-CS leads, the pacing threshold was 1.2 ± 0.7 V × ms at implant and 1.1 ± 0.5 V × ms at 2-year follow-up (P = 0.52). CONCLUSIONS The use of ventricular pacing entirely through the CS is an effective and minimally invasive method that provides stable pacing for patients with prior TV surgery in whom transvenous lead placement either is not possible or is relatively contraindicated.
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Noheria A, van Zyl M, Scott LR, Srivathsan K, Madhavan M, Asirvatham SJ, McLeod CJ. Single-site ventricular pacing via the coronary sinus in patients with tricuspid valve disease. Europace 2019; 20:636-642. [PMID: 28339945 DOI: 10.1093/europace/euw422] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/01/2016] [Indexed: 11/14/2022] Open
Abstract
Aims To evaluate coronary sinus single-site (CSSS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CSSS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RVSS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CSCRT). Main outcomes of interest were lead stability, electrical lead parameters and change in LVEF during long-term follow-up. Successful CSSS pacing was accomplished in all 23 patients without any procedural complications. During the 5.3 ± 2.8-year follow-up 22/23 (95.7%) leads were functional with stable pacing and sensing parameters, and 1/23 (4.3%) was extracted for unrelated reasons. Compared to CSSS leads, the lead revision/abandonment was similar with RVSS leads (Hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.03, 22.0), but was higher with CSCRT leads (HR 7.41, 95% CI 1.30, 139.0). There was no difference in change in LVEF between CSSS and RVSS groups (-2.4 ± 11.0 vs. 1.5 ± 12.8, P = 0.76), but LVEF improved in CSCRT group (11.2 ± 16.5%, P = 0.002). Fluoroscopy times were longer during implantation of CSSS compared to RVSS leads (25.6 ± 24.6 min vs. 12.3 ± 18.6 min, P = 0.049). Conclusion In patients with normal LVEF, single-site ventricular pacing via the coronary sinus is a feasible, safe and reliable alternative to right ventricular pacing.
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Affiliation(s)
- Amit Noheria
- Cardiovascular Division, Washington University, School of Medicine, 660 S. Euclid Ave, Campus Box 8086, St. Louis, MO, USA
| | - Martin van Zyl
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Luis R Scott
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Malini Madhavan
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
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Shafquat A, Salahuddin N, Aldawood W, Alassas K, Al-Ghamdi B, Fadel BM. Bioprosthetic tricuspid valve dysfunction in patients with transvalvular or epicardial pacing leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:1495-1499. [PMID: 30221784 DOI: 10.1111/pace.13504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/03/2018] [Accepted: 08/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Dysfunction of native tricuspid valves due to transvenous pacing leads is well described. Patients with bioprosthetic tricuspid valve (BTV) who need ventricular pacing are often advised epicardial lead placement to avoid potential damage to the BTV although there are no data to support this. OBJECTIVE The aim of the study was to assess the frequency of BTV dysfunction in patients with permanent transvenous right ventricular pacemaker lead and compare it to patients with epicardial leads. METHODS A retrospective review of patients with BTV with ventricular pacing lead was conducted. Demographics, lead, BTV, and echocardiographic data were collected. Frequency of BTV dysfunction (moderate or severe) regurgitation or stenosis was compared between epicardial and transvalvular lead groups. RESULTS Forty-six patients with BTV and ventricular pacing lead (20 transvalvular and 26 epicardial leads) were identified. Mean age was 46 years with the majority being female (85%) and with rheumatic heart disease (87%). Both groups were similar in age, sex, and indications for BTV. Mean echocardiographic follow-up was for 5.5 years (±4.1 years). BTV dysfunction was similar between the transvalvular group with six (30%) patients and the epicardial group with five (19.2%) patients. The incidence of BTV dysfunction was greater in patients in sinus rhythm compared to patients in atrial fibrillation (50% vs 10%, P = 0.004). CONCLUSION Development of BTV dysfunction is similar in patients with transvalvular ventricular leads and epicardial leads. The incidence of BTV dysfunction was higher in patients with sinus rhythm compared to atrial fibrillation.
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Affiliation(s)
- Azam Shafquat
- Heart Center, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nawal Salahuddin
- Department of Adult Critical Care, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Wafa Aldawood
- Heart Center, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Khadija Alassas
- Heart Center, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Bandar Al-Ghamdi
- Heart Center, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
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13
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Schleifer JW, Pislaru SV, Lin G, Powell BD, Espinosa R, Koestler C, Thome T, Polk L, Li Z, Asirvatham SJ, Cha YM. Effect of ventricular pacing lead position on tricuspid regurgitation: A randomized prospective trial. Heart Rhythm 2018; 15:1009-1016. [DOI: 10.1016/j.hrthm.2018.02.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Indexed: 11/25/2022]
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Zheng C, Lin WQ, Lin YZ, Lian H, Liu ZR, Chen JH, Lin JF. Case presentation: implantation of cardiac resynchronization therapy pacemaker via the coronary sinus in a patient with triple valve replacement. BMC Cardiovasc Disord 2018; 18:37. [PMID: 29466958 PMCID: PMC5822565 DOI: 10.1186/s12872-018-0775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/13/2018] [Indexed: 11/30/2022] Open
Abstract
Background In patients with triple valve replacement developing third-degree atrioventricular block (AVB), the most appropriate approach for permanent pacemaker implantation remains questionable. Case presentation In this case presentation, we first described the approach of implantation of the cardiac resynchronization therapy pacemaker (CRT-P) via one bipolar pacing lead in middle cardiac vein (MCV) and one quadripolar pacing lead in anterior interventricular vein (AIV) in a patient developing complete AVB, who had been previously diagnosed with rheumatic valvular heart disease with triple valve replaced. After the CRT-P implantation, the two pacing leads in coronary sinus (CS) provided a dual-site ventricular pacing from the anterior septum and posterior septum, which resulted in a narrow QRS complex and an increased ventricular synchrony. During the long-term follow-up, no deterioration of heart function was documented and pacing parameters remained good. Conclusion In this patient developing complete AVB with triple valve replaced, our approach of CRT-P implantation provides an effective and reliable ventricular pacing, and is an alternative option when transvenous right ventricular pacing, transseptal left ventricular pacing and transpericardial epicardium pacing are not possible. Further prospective randomized trials are required to confirm the efficiency of our approach of dual-site ventricular pacing by CRT-P in this kind patients.
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Affiliation(s)
- Cheng Zheng
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China
| | - Wei-Qian Lin
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China
| | - Yuan-Zheng Lin
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China
| | - Hao Lian
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China
| | - Zhi-Rui Liu
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China
| | - Jia-Hui Chen
- Department of Cardiology, Taishun general hospital, Wenzhou, 325000, China
| | - Jia-Feng Lin
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, 325000, China.
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Leads leading leaflets to leak. J Thorac Cardiovasc Surg 2018; 155:1496-1497. [PMID: 29370904 DOI: 10.1016/j.jtcvs.2017.12.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 12/28/2017] [Indexed: 11/21/2022]
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Takeuchi D, Yagishita D, Toyohara K, Nishimura T, Park IS, Shoda M. Transvenous biventricular pacing in double-inlet left ventricle following ventricular septation and atrioventricular valve replacement. Europace 2017; 19:1987. [PMID: 28398485 DOI: 10.1093/europace/euw322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Daiji Takeuchi
- Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Daigo Yagishita
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Keiko Toyohara
- Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Tomomi Nishimura
- Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - In-Sam Park
- Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
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Zha K, Cui K, Liu X, Fang Y. Clinical investigation of left ventricular pacing using coronary sinus in patients with mechanical prosthetic tricuspid valve replacement. Clin Cardiol 2017; 40:1139-1144. [PMID: 29166536 DOI: 10.1002/clc.22800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 08/10/2017] [Accepted: 08/16/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although transvenous right ventricular (RV) endocardial lead placement is routine practice in clinical pacing, RV inaccessibility in certain clinical situations mandates the search for other sites. HYPOTHESIS This study is aimed to verify whether left ventricular lead through coronary sinus is safe and efficient. METHODS Based on a retrospective analysis of a single-center series of 4 patients with inaccessibility for RV pacing, we report on the feasibility and reliability of coronary sinus (CS) pacing via left ventricular (LV) lead, which usually is used in cardiac resynchronization therapy. Four patients with valvular heart disease and bradycardias post-mechanical prosthetic tricuspid valve replacement were studied. The LV leads were implanted into the lateral vein or great cardiac vein of the CS, and all parameters were programmed postprocedure. RESULTS In all cases procedures yielded favorable parameters, with 1 CS dissection. At long-term follow-up, there was no threshold increase or lead dislocation. CONCLUSIONS LV lead implantation through the CS appears safe and efficacious in patients with inaccessibility for RV pacing.
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Affiliation(s)
- Kelan Zha
- Department of Cardiology, West China School of Medicine, Sichuan University, Chengdu, China.,Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Kaijun Cui
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xingbin Liu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Fang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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18
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Burri H, Müller H, Kobza R, Sticherling C, Ammann P, Zerlik H, Stettler C, Klersy C, Prinzen F, Auricchio A. RIght VErsus Left Apical transvenous pacing for bradycardia: Results of the RIVELA randomized study. Indian Pacing Electrophysiol J 2017; 17:171-175. [PMID: 29110936 PMCID: PMC5784604 DOI: 10.1016/j.ipej.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 10/24/2017] [Indexed: 11/25/2022] Open
Abstract
Aims To compare cardiac function when pacing from the right or left ventricular apex in patients with preserved left ventricular systolic function, at 1-year follow-up. Methods Prospective, multicentre centre randomizing conventional right ventricular apical (RVA) versus left ventricular apical (LVA) pacing using a coronary sinus lead in patients requiring ventricular pacing for bradycardia. Follow-up was performed using 3D-echocardiography at 6 and 12 months. Results A total of 36 patients (age 75.4 ± 8.7 years, 21 males) were enrolled (17 patients in the RVA group and 19 patients in the LVA group). A right ventricular lead was implanted in 8 patients in the LVA group, mainly because of high capture thresholds. There were no differences in the primary endpoint of LVEF at 1 year (60.4 ± 7.1% vs 62.1 ± 7.2% for the RVA and LVA groups respectively, P = 0.26) nor in any of the secondary endpoints (left ventricular dimensions, left ventricular diastolic function, right ventricular systolic function and tricuspid/mitral insufficiency). LVEF did not change significantly over follow-up in either group. Capture thresholds were significantly higher in the LVA group, and two patients had unexpected loss of capture of the coronary sinus lead during follow-up. Conclusions Left univentricular pacing seems to be comparable to conventional RVA pacing in terms of ventricular function at up to 1 year follow-up, and is an option to consider in selected patients (e.g. those with a tricuspid valve prosthesis).
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Affiliation(s)
| | | | | | | | | | | | | | - Catherine Klersy
- Service of Biometry & Clinical Epidemiology, Research Department, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Frits Prinzen
- Department of Physiology, Cardiovascular Research Institute, University of Maastricht, The Netherlands
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19
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Reichart D, Schofer N, Deuschl F, Schaefer A, Blankenberg S, Reichenspurner H, Schaefer U, Conradi L. Transcatheter Tricuspid Valve-In-Ring and Aortic Valve-In-Valve Implantation. Thorac Cardiovasc Surg Rep 2017; 6:e29-e31. [PMID: 28929044 PMCID: PMC5602643 DOI: 10.1055/s-0037-1606345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/19/2017] [Indexed: 11/16/2022] Open
Abstract
Background
Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce.
Case Description
Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc., Irvine, California, United States) THV in tricuspid position.
Conclusion
This case demonstrates feasibility of concomitant transcatheter aortic ViV and tricuspid ViR procedures.
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Affiliation(s)
- Daniel Reichart
- Department of Cardiovascular Surgery, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Niklas Schofer
- Department of General and Interventional Cardiology, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Florian Deuschl
- Department of General and Interventional Cardiology, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Andreas Schaefer
- Department of Cardiovascular Surgery, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Hermann Reichenspurner
- Department of Cardiovascular Surgery, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Ulrich Schaefer
- Department of General and Interventional Cardiology, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | - Lenard Conradi
- Department of Cardiovascular Surgery, Universitätsklinikum Hamburg-Eppendorf, Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
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Soydan E, Engin Ç, Zoghi M. Uncommon but life threatening complication of the left ventricle pacemaker lead: Coronary sinus perforation. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2017. [DOI: 10.1016/j.ijcac.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Chang JD, Manning WJ, Ebrille E, Zimetbaum PJ. Tricuspid Valve Dysfunction Following Pacemaker or Cardioverter-Defibrillator Implantation. J Am Coll Cardiol 2017; 69:2331-2341. [DOI: 10.1016/j.jacc.2017.02.055] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/13/2017] [Accepted: 02/20/2017] [Indexed: 10/19/2022]
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