YuLiang Chai, Qiang Liu, Zhiwen Chen, Wenjing Zhang, Yuanqing Liu
{"title":"Pacemaker lead extraction saved a severe lead-induced tricuspid regurgitation: a case report.","authors":"YuLiang Chai, Qiang Liu, Zhiwen Chen, Wenjing Zhang, Yuanqing Liu","doi":"10.1093/ehjcr/ytae560","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case summary: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"8 11","pages":"ytae560"},"PeriodicalIF":0.8000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536175/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytae560","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
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.