Pacemaker lead extraction saved a severe lead-induced tricuspid regurgitation: a case report.

Pub Date : 2024-10-18 eCollection Date: 2024-11-01 DOI:10.1093/ehjcr/ytae560

YuLiang Chai, Qiang Liu, Zhiwen Chen, Wenjing Zhang, Yuanqing Liu

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Abstract

Background: Pacemaker lead-induced tricuspid regurgitation is a common complication after cardiac implantable electronic device (CIED) implantation. Cardiac implantable electronic device lead removal is a challenge procedure.

Case summary: A 72-year-old lady was admitted due to worsening heart failure. She had a history of permanent atrial fibrillation and had a permanent single-chamber pacemaker implanted 8 years ago due to complete heart block. Transthoracic echocardiography identified severe lead-related tricuspid regurgitation. The patient underwent successful lead extraction and received a new implantation of left bunch bundle area pacing. Transthoracic echocardiographic examination 2 days after the procedure showed a significant decrease of the tricuspid regurgitation. The patient also reported an improvement in heart failure symptoms.

Discussion: Pacemaker lead-related tricuspid regurgitation introduces negative haemodynamic overload, carrying high risk for the development of heart failure and worse outcome. The present case shows a rapid relief of symptom and improvement of echocardiography findings, indicating the significance of mechanistic approach in the treatment of lead-related tricuspid mechanical interference.

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起搏器导联取出术挽救了严重的导联诱发的三尖瓣反流：病例报告。

背景：起搏器导联引起的三尖瓣反流是心脏植入式电子装置（CIED）植入术后常见的并发症。病例摘要：一位 72 岁的女士因心力衰竭恶化入院。她有永久性心房颤动病史，8 年前因完全性心脏传导阻滞植入了永久性单腔起搏器。经胸超声心动图检查发现了严重的导联相关三尖瓣反流。患者成功拔除了导联，并接受了左束区起搏器的新植入。术后两天的经胸超声心动图检查显示，三尖瓣反流明显减轻。患者还表示心衰症状有所改善：讨论：起搏器导联相关的三尖瓣反流会导致负性血流动力学负荷过重，极易引发心力衰竭并导致预后恶化。本病例显示症状迅速缓解，超声心动图检查结果也有所改善，表明在治疗起搏器导联相关三尖瓣机械性干扰时采用机械方法具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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