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Outcomes of Tricuspid Regurgitation After Lead Extraction
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  • Colby Shanafelt,
  • Thomas G. Middour,
  • Rand Ibrahim,
  • Miguel Leal,
  • Michael Lloyd,
  • Anand Shah,
  • Stacy B. Westerman,
  • Mikhael El-Chami,
  • Faisal M. Merchant,
  • Neal Bhatia
Colby Shanafelt
Emory University
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Thomas G. Middour
Emory University
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Rand Ibrahim
Emory University
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Miguel Leal
Emory University
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Michael Lloyd
Emory University
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Anand Shah
Emory University
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Stacy B. Westerman
Emory University
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Mikhael El-Chami
Emory University
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Faisal M. Merchant
Emory University
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Neal Bhatia
Emory University

Corresponding Author:[email protected]

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Abstract

Background: Transvenous leads have been implicated in tricuspid valve (TV) dysfunction, but limited data are available regarding the effect of extracting leads across the TV on valve regurgitation. Objective: The aim of this study is to quantify tricuspid regurgitation (TR) before and after lead extraction and identify predictors of worsening TR. Methods: We studied 321 patients who had echocardiographic data before and after lead extraction. TR was graded on a scale (0=none/trivial, 1=mild, 2=moderate, 3=severe). A change of > 1 grade following extraction was considered significant. Results: A total of 321 patients underwent extraction of a total of 338 leads across the TV (1.05 ± 0.31 leads across the TV per patient). There was no significant difference in average TR grade pre- and post-extraction (1.18 ± 0.91 vs. 1.15 ± 0.87; p=0.79). TR severity increased after extraction in 84 patients, but was classified as significantly worse (i.e. > 1 grade change in severity) in only 8 patients (2.5%). Use of laser lead extraction was associated with a higher rate of worsening TR post-extraction (44.0% vs. 31.6%, p=0.04). Conclusion: In our single-center analysis, extraction of leads across the TV did not significantly affect the extent of TR in most patients. Laser lead extraction was associated with a higher rate of worsening TR after extraction.
19 Oct 2023Submitted to Journal of Cardiovascular Electrophysiology
20 Oct 2023Review(s) Completed, Editorial Evaluation Pending
20 Oct 2023Assigned to Editor
20 Oct 2023Submission Checks Completed
22 Oct 2023Reviewer(s) Assigned