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Severe tricuspid regurgitation due to interactions with right ventricular permanent pacemaker or defibrillator leads.

Cory R TrankleZachary M GertzJayanthi N KoneruVigneshwar KasirajanPatricia NicolatoHem L BhardwajKenneth A EllenbogenGautham Kalahasty
Published in: Pacing and clinical electrophysiology : PACE (2018)
Although thought to be a rare event, permanent pacemakers and implantable cardioverter-defibrillators with right ventricular intracardiac leads have the potential to induce tricuspid valve dysfunction. Adverse lead-valve interactions can take place through a variety of mechanisms including damage at the time of implantation, leaflet pinning, or long-term fibrosis encapsulating the leaflet tissue. Clinical manifestations can display a wide range of severity, as well as a highly variable time span between implantation and hemodynamic deterioration. This review aims to describe the potential pathophysiologic effects of intracardiac device leads on the tricuspid valve, with a focus on ideal diagnostic strategies and treatment options once lead-induced valvular dysfunction is suspected.
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