Skip to main content
SpringerLink
Log in

Leadless pacemaker implantation following tricuspid interventions: multicenter collaboration of feasibility and safety

  • ORIGINAL RESEARCH
  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Permanent pacing is often required following valve intervention (either surgical or percutaneous); however, tricuspid interventions pose specific challenges to conventional pacing. Therefore, leadless pacemaker (LP) implantation may be the preferred strategy when permanent pacing is required after tricuspid valve intervention.

Purpose

To report periprocedural outcomes and follow-up of patients undergoing implantation of a LP system following tricuspid valve interventions.

Methods

Patients with previous tricuspid valve intervention at the time of attempted implantation of a LP (MicraTM, Medtronic, Minneapolis, MN, USA) were included.

Results

Between 2019 and 2022, 40 patients underwent LP implantations following tricuspid interventions in 5 large tertiary centers. The mean age was 68.9 ± 13.7 years, and 48% patients were male. The indication for pacing was as following: AVB in 27 (68%) patients, AF with slow ventricular response in 10 (25%) patients, and refractory rapid atrial fibrillation (AF) referred to AV junction ablation in 3 (7%) patients. Most of the patients received Micra VR (78%). The procedure was successful in all patients. The mean procedural time is 58 ± 32 min, and the median fluoroscopy time is 7.5 min. Electrical parameters were within normal range (threshold: 1.35 ± 1.2 V@0.24 ms, impedance: 772 ± 245 Ohm, R-wave: 6.9 ± 5.4 mV). No acute complications were observed. During a mean follow-up of 10 months, electrical parameters remained stable, and 4 deaths were occurred (not related to the procedure).

Conclusion

A LP is a safe and efficient option following tricuspid valve interventions.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mar PL, Angus CR, Kabra R, Migliore CK, Goswami R, John LA, et al. Perioperative predictors of permanent pacing and long-term dependence following tricuspid valve surgery: a multicentre analysis. Europace. 2017;19(12):1988–93.

    Article  PubMed  Google Scholar 

  2. Monteiro C, Ferrari ADL, Caramori PRA, Carvalho LAF, Siqueira DAA, Thiago L, et al. Permanent pacing after transcatheter aortic valve implantation: incidence, predictors and evolution of left ventricular function. Arq Bras Cardiol. 2017;109(6):550–9.

    PubMed  PubMed Central  Google Scholar 

  3. Udo EO, Zuithoff NP, van Hemel NM, de Cock CC, Hendriks T, Doevendans PA, et al. Incidence and predictors of short- and long-term complications in pacemaker therapy: the FOLLOWPACE study. Heart Rhythm. 2012;9(5):728–35.

    Article  PubMed  Google Scholar 

  4. Ostergaard L, Valeur N, Ihlemann N, Smerup MH, Bundgaard H, Gislason G, et al. Incidence and factors associated with infective endocarditis in patients undergoing left-sided heart valve replacement. Eur Heart J. 2018;39(28):2668–75.

    Article  PubMed  Google Scholar 

  5. Trankle CR, Gertz ZM, Koneru JN, Kasirajan V, Nicolato P, Bhardwaj HL, et al. Severe tricuspid regurgitation due to interactions with right ventricular permanent pacemaker or defibrillator leads. Pacing Clin Electrophysiol. 2018;41(7):845–53.

    Article  PubMed  Google Scholar 

  6. Martins RP, Galand V, Leclercq C, Daubert JC. Cardiac electronic implantable devices after tricuspid valve surgery. Heart Rhythm. 2018;15(7):1081–8.

    Article  PubMed  Google Scholar 

  7. Afzal MR, Daoud EG, Hussain S, Lloyd MS, Ellis C, Nangia V, et al. Multicenter experience of feasibility and safety of leadless pacemakers across bioprosthetic and repaired tricuspid valves. JACC Clin Electrophysiol. 2019;5(9):1093–4.

    Article  PubMed  Google Scholar 

  8. Theis C, Huber C, Kaesemann P, Kaiser B, Heinrich H, Albert M, et al. Implantation of leadless pacing systems in patients early after tricuspid valve surgery: a feasible option. Pacing Clin Electrophysiol. 2020;43(12):1486–90.

    Article  PubMed  Google Scholar 

  9. Garweg C, Vandenberk B, Foulon S, Poels P, Haemers P, Ector J, et al. Leadless pacemaker for patients following cardiac valve intervention. Arch Cardiovasc Dis. 2020;113(12):772–9.

    Article  PubMed  Google Scholar 

  10. Chang JD, Manning WJ, Ebrille E, Zimetbaum PJ. Tricuspid valve dysfunction following pacemaker or cardioverter-defibrillator implantation. J Am Coll Cardiol. 2017;69(18):2331–41.

    Article  PubMed  Google Scholar 

  11. Eleid MF, Blauwet LA, Cha YM, Connolly HM, Brady PA, Dearani JA, et al. Bioprosthetic tricuspid valve regurgitation associated with pacemaker or defibrillator lead implantation. J Am Coll Cardiol. 2012;59(9):813–8.

    Article  PubMed  Google Scholar 

  12. Morani G, Bolzan B, Pepe A, Ribichini FL. Leadless pacemaker through tricuspid bioprosthetic valve: Early experience. J Arrhythm. 2021;37(2):414–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hwang J, Han S, Park HS, Lee CH, Kim IC, Jang WS. Implantation of a leadless pacemaker in a patient with mechanical tricuspid valve. HeartRhythm Case Rep. 2022;8(4):284–7.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kerwin SA, Mayotte MJ, Gornick CC. Transcatheter pacemaker implantation in a patient with a bioprosthetic tricuspid valve. J Interv Card Electrophysiol. 2015;44(1):89–90.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ollitrault P. Leadless pacemaker implantation in a patient with previous aortic, mitral, and tricuspid valve interventions. J Invasive Cardiol. 2021;33(10):E841.

    PubMed  Google Scholar 

  16. Turdubaev A, Fink T, Eitz T, Imnadze G. Transfemoral leadless pacemaker implantation after transcatheter tricuspid valve in ring implantation. Clin Res Cardiol. 2024;113(1):187–9.

    Article  PubMed  Google Scholar 

  17. Terricabras M, Gul EE, Khaykin Y. Successful implantation of a leadless pacemaker in a patient with a tricuspid clip. CJC Open. 2021;3(10):1310–2.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tang GH, Kaple R, Cohen M, Dutta T, Undemir C, Ahmad H, et al. First percutaneous Micra leadless pacemaker implantation and tricuspid valve repair with MitraClip NT for lead-associated severe tricuspid regurgitation. EuroIntervention. 2017;12(15):e1845–8.

    Article  PubMed  Google Scholar 

  19. Adukauskaite A, Hintringer F, Dichtl W, Muller S. Implantation of leadless pacemaker through neo-orifice after tricuspid valve edge-to-edge repair. Europace. 2020;22(6):869.

    Article  PubMed  Google Scholar 

  20. Reynolds D, Duray GZ, Omar R, Soejima K, Neuzil P, Zhang S, et al. A leadless intracardiac transcatheter pacing system. N Engl J Med. 2016;374(6):533–41.

    Article  CAS  PubMed  Google Scholar 

  21. Moore SKL, Chau KH, Chaudhary S, Rubin G, Bayne J, Avula UMR, et al. Leadless pacemaker implantation: a feasible and reasonable option in transcatheter heart valve replacement patients. Pacing Clin Electrophysiol. 2019;42(5):542–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Beurskens NEG, Tjong FVY, de Bruin-Bon RHA, Dasselaar KJ, Kuijt WJ, Wilde AAM, et al. Impact of leadless pacemaker therapy on cardiac and atrioventricular valve function through 12 months of follow-up. Circ Arrhythm Electrophysiol. 2019;12(5): e007124.

    Article  PubMed  Google Scholar 

  23. Hai JJ, Mao Y, Zhen Z, Fang J, Wong CK, Siu CW, et al. Close proximity of leadless pacemaker to tricuspid annulus predicts worse tricuspid regurgitation following septal implantation. Circ Arrhythm Electrophysiol. 2021;14(5): e009530.

    Article  PubMed  Google Scholar 

  24. Arkles JS, Epstein AE. Leadless pacemakers and the tricuspid valve: can you believe it? Can this be true? Circ Arrhythm Electrophysiol. 2019;12(5): e007375.

    Article  PubMed  Google Scholar 

  25. Gul EE, Haseeb YB, Haseeb S, Abuelatta R, Al AO. Successful leadless pacemaker implantation in a patient with profound bradycardia following transcatheter aortic valve replacement and mitral valve-in-valve procedure. Turk Kardiyol Dern Ars. 2020;48(4):443–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiac Electrophysiology, Istanbul Atlas University Medicine Hospital, Istanbul, Turkey

    Enes Elvin Gul & Zeki Dogan

  2. European Hospital Georges Pompidou, Paris, France

    Pierre Baudinaud & Victor Waldmann

  3. The Olga and Lev Leviev Heart Center, The Chaim Sheba Medical Center, Tel Aviv, Israel

    Avi Sabbag & Yousef Jubeh

  4. Le Millénaire Private Hospital, Montpellier, France

    Nicholas Clementy

  5. Trousseau University Hospital Centre, Tours, France

    Arnaud Bisson

  6. Electrophysiology Unit, Department of Cardiology, Caen University Hospital, Avenue de La Côte de Nacre, 14000, Caen, France

    Pierre Ollitraut

  7. Department of Electrophysiology, ARNAS Civico-Di Cristina-Benfratelli, 90127, Palermo, Italy

    Sergio Conti

  8. Grenobles Alpes University Hospital Centre, Grenoble, France

    Adrian Carabelli

Authors
  1. Enes Elvin Gul
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierre Baudinaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Victor Waldmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Avi Sabbag
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yousef Jubeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicholas Clementy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Arnaud Bisson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pierre Ollitraut
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sergio Conti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Adrian Carabelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Zeki Dogan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors have made substantive contributions to the study, and all authors endorse the data and conclusions.

Corresponding author

Correspondence to Enes Elvin Gul.

Ethics declarations

Ethics approval

This retrospective study was approved by the Institutional Review Board of Istanbul Atlas University.

Conflict of interest

The authors declare no competing interests.

Additional information

All authors declare that the manuscript, as submitted or its essence in another version, is not under consideration for publication elsewhere, and it will not be submitted elsewhere until a final decision is made by the editors of the Journal of Interventional Cardiac Electrophysiology.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gul, E.E., Baudinaud, P., Waldmann, V. et al. Leadless pacemaker implantation following tricuspid interventions: multicenter collaboration of feasibility and safety. J Interv Card Electrophysiol (2024). https://doi.org/10.1007/s10840-024-01796-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10840-024-01796-w

Keywords

Search

Navigation