Impact of Leadless Pacemaker Therapy on Cardiac and Atrioventricular Valve Function Through 12 Months of Follow-Up
| Autor: | Reinoud E. Knops, Wichert J. Kuijt, Fleur V.Y. Tjong, Arthur A.M. Wilde, Rianne H.A.C.M. de Bruin-Bon, Kosse J. Dasselaar, Niek E.G. Beurskens |
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| Přispěvatelé: | Graduate School, ACS - Heart failure & arrhythmias, Cardiology, ACS - Amsterdam Cardiovascular Sciences |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Pacemaker Artificial Time Factors Ventricular Dysfunction Right Risk Assessment Ventricular Function Left Cardiac dysfunction Ventricular Dysfunction Left Tricuspid Valve Insufficiency Risk Factors Physiology (medical) Internal medicine Mitral valve medicine Humans cardiovascular diseases Aged Retrospective Studies Aged 80 and over Atrioventricular valve Tricuspid valve business.industry Cardiac Pacing Artificial Mitral Valve Insufficiency Equipment Design Pacemaker leads medicine.anatomical_structure Treatment Outcome Cardiology cardiovascular system Ventricular Function Right Mitral Valve Female Tricuspid Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. Arrhythmia and electrophysiology, 12(5). Lippincott Williams and Wilkins |
| ISSN: | 1941-3084 1941-3149 |
| Popis: | Background: Endocardial pacemaker leads and right ventricular (RV) pacing are well-known causes of tricuspid valve, mitral valve, and cardiac dysfunction. Lead-related adverse consequences can potentially be mitigated by leadless pacemaker (LP) therapy by eliminating the presence of a transvalvular lead. This study assessed the impact of LP placement on cardiac and valvular structure and function. Methods: Echocardiographic studies before and 12±1 months after LP implantation were performed between January 2013 and May 2018 at our center and compared with age- and sex-matched controls of dual-chamber transvenous pacemaker recipients. Results: A total of 53 patients receiving an LP were included, of whom 28 were implanted with a Nanostim and 25 with a Micra LP device. Tricuspid valve regurgitation was graded as being more severe in 23 (43%) patients at 12±1 months compared with baseline ( P P =0.03). An increase in mitral valve regurgitation was observed in 38% of patients ( P =0.006). LP implantation resulted in a reduction of RV function, according to a lower tricuspid annular plane systolic excursion ( P =0.003) and RV tricuspid lateral annular systolic velocity ( P =0.02), and a higher RV Tei index ( P =0.04). LP implantation was further associated with a reduction of left ventricular ejection fraction ( P =0.03) and elevated left ventricular Tei index ( P =0.003). The changes in tricuspid valve regurgitation in the LP group were similar to the changes in the dual-chamber transvenous pacemaker control group (43% versus 38%, respectively; P =0.39). Conclusions: LP therapy is associated with an increase in tricuspid valve dysfunction through 12 months of follow-up; yet it was comparable to dual-chamber transvenous pacemaker systems. Furthermore, LP therapy seems to adversely impact mitral valve and biventricular function. |
| Databáze: | OpenAIRE |
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