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Vol 11, No 5 (2016)
Original Papers
Published online: 2016-09-15
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Tricuspid regurgitation after implantable cardioverter-defibrillator implantation in patients with arrhythmogenic right ventricular cardiomyopathy

Krzysztof Bernard Poślednik, Olgierd Woźniak, Elżbieta Katarzyna Biernacka, Marek Konka, Andrzej Przybylski, Łukasz Szumowski, Piotr Hoffman
DOI: 10.5603/FC.a2016.0085
·
Folia Cardiologica 2016;11(5):365-371.

open access

Vol 11, No 5 (2016)
Original Papers
Published online: 2016-09-15

Abstract

Introduction. The problem of lead-induced tricuspid regurgitation (LITR) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is poorly investigated. Patients with high risk of adverse outcome usually receive implantable cardioverter-defibrillator (ICD) as a prevention of sudden cardiac death (SCD). nfortunately, the insertion of ICD into the right ventricle is supposed to exacerbate tricuspid regurgitation.
As ICD (or cardiac resynchronization therapy defibrillator) seems to be necessity in prevention of SCD in quite large group of patients, we aimed to evaluate frequency of LITR and further outcome in these persons.
Material and methods. In a database of 55 patients with ARVC and ICD implanted in prevention of SCD, we selected 35 patients (mean age 48.78 ± 13.56 years) with data suitable for analysis. Based on the results of echocardiography, study population was divided into 2 groups: TR+ group with worsening of tricuspid regurgitation (TR) defined as its deterioration to higher grade and TR– group (without worsening of TR).
Results. In 65.71% of patients TR worsened after ICD implantation. Mean time of observation was 91.06 ± 55.32 months. In TR+ group, 2 patients (8.7%) died because of heart failure and 1 patient died in a traffic accident. In TR– group 1 patient (8.33%) died because of heart failure and 1 patient had heart transplantation (results were statistically insignificant).
Conclusions. We couldn’t prove that the worsening of TR was associated with worsening of clinical outcome. Further
studies are needed to assess an influence of LITR on prognosis in patients with ARVC and ICD implanted.

Abstract

Introduction. The problem of lead-induced tricuspid regurgitation (LITR) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is poorly investigated. Patients with high risk of adverse outcome usually receive implantable cardioverter-defibrillator (ICD) as a prevention of sudden cardiac death (SCD). nfortunately, the insertion of ICD into the right ventricle is supposed to exacerbate tricuspid regurgitation.
As ICD (or cardiac resynchronization therapy defibrillator) seems to be necessity in prevention of SCD in quite large group of patients, we aimed to evaluate frequency of LITR and further outcome in these persons.
Material and methods. In a database of 55 patients with ARVC and ICD implanted in prevention of SCD, we selected 35 patients (mean age 48.78 ± 13.56 years) with data suitable for analysis. Based on the results of echocardiography, study population was divided into 2 groups: TR+ group with worsening of tricuspid regurgitation (TR) defined as its deterioration to higher grade and TR– group (without worsening of TR).
Results. In 65.71% of patients TR worsened after ICD implantation. Mean time of observation was 91.06 ± 55.32 months. In TR+ group, 2 patients (8.7%) died because of heart failure and 1 patient died in a traffic accident. In TR– group 1 patient (8.33%) died because of heart failure and 1 patient had heart transplantation (results were statistically insignificant).
Conclusions. We couldn’t prove that the worsening of TR was associated with worsening of clinical outcome. Further
studies are needed to assess an influence of LITR on prognosis in patients with ARVC and ICD implanted.

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Keywords

arrhythmogenic right ventricular cardiomyopathy, tricuspid regurgitation, implantable cardioverter-defibrillator, sudden cardiac death

About this article
Title

Tricuspid regurgitation after implantable cardioverter-defibrillator implantation in patients with arrhythmogenic right ventricular cardiomyopathy

Journal

Folia Cardiologica

Issue

Vol 11, No 5 (2016)

Pages

365-371

Published online

2016-09-15

DOI

10.5603/FC.a2016.0085

Bibliographic record

Folia Cardiologica 2016;11(5):365-371.

Keywords

arrhythmogenic right ventricular cardiomyopathy
tricuspid regurgitation
implantable cardioverter-defibrillator
sudden cardiac death

Authors

Krzysztof Bernard Poślednik
Olgierd Woźniak
Elżbieta Katarzyna Biernacka
Marek Konka
Andrzej Przybylski
Łukasz Szumowski
Piotr Hoffman

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