The challenge of endocardial right ventricular pacing in patients with a tricuspid annuloplasty ring and severe tricuspid regurgitation

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dc.contributor.authorKistler, P.
dc.contributor.authorSanders, P.
dc.contributor.authorDavidson, N.
dc.contributor.authorMond, H.
dc.date.issued2002
dc.description© 2002 by Futura Publishing Company, Inc.
dc.description.abstractOn occasion, patients with a tricuspid annuloplasty ring may require permanent cardiac pacing. Although it is technically possible to pass a ventricular transvenous lead through a tricuspid valve with an annuloplasty ring, the procedure is complicated by considerable chamber enlargement and mechanical distortion of the tricuspid valve often with severe residual tricuspid regurgitation. Over a 25-month period, transvenous ventricular lead placement following insertion of a tricuspid annuloplasty ring was successfully performed in five patients (three women). The patient mean age was 66 years (range 55-77 years). Four cases had slow atrial fibrillation and another paroxysmal atrial fibrillation requiring His-bundle ablation. Two patients had mitral valve replacement and two aortic and mitral valve replacements. All patients had residual severe to torrential tricuspid regurgitation. Seven ventricular steroid-eluting screw-in leads were used. Single leads were used in three cases, whereas in two others, two ventricular leads were attached to a dual chamber pulse generator. Although technically difficult, ventricular lead placement was successful using standard guidewires with broad curvatures. Satisfactory acute and follow-up stimulation thresholds and sensing were obtained with the only complication being an intraoperative lead dislodgement, prompting a second ventricular lead. Successful transvenous lead placement across a tricuspid annuloplasty ring is possible.
dc.description.statementofresponsibilityPeter M. Kistler, Prashanthan Sanders, Neil C. Davidson, and Harry G. Mond
dc.identifier.citationPacing and Clinical Electrophysiology, 2002; 25(2):201-205
dc.identifier.doi10.1046/j.1460-9592.2002.00201.x
dc.identifier.issn0147-8389
dc.identifier.issn1540-8159
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]
dc.identifier.urihttp://hdl.handle.net/2440/39110
dc.language.isoen
dc.publisherFutura Publ Co
dc.source.urihttp://www.blackwell-synergy.com/doi/abs/10.1046/j.1460-9592.2002.00201.x
dc.subjectventricular pacing
dc.subjecttricuspid annuloplasty
dc.titleThe challenge of endocardial right ventricular pacing in patients with a tricuspid annuloplasty ring and severe tricuspid regurgitation
dc.typeJournal article
pubs.publication-statusPublished

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