Author + information
- Received June 15, 2018
- Revision received September 4, 2018
- Accepted September 6, 2018
- Published online April 1, 2019.
- Karima Addetia, MDa,
- Serge C. Harb, MDa,
- Rebecca T. Hahn, MDb,
- Samir Kapadia, MDc and
- Roberto M. Lang, MDc,∗ ()
- aSection of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois
- bColumbia University Medical Center, New York Presbyterian Hospital, New York, New York
- cDepartment of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- ↵∗Address for correspondence:
Dr. Roberto M. Lang, Section of Cardiology, University of Chicago Medical Center, 5758 South Maryland Avenue, MC 9067, Chicago, Illinois 60637.
With the expanding use of cardiac implantable electronic device (CIEDs) in an ever-aging population, the looming problem of CIED-associated interference with the tricuspid valve is significant. The first pacemaker was implanted in 1958 for severe symptomatic bradycardia. The concept of a device to avert sudden cardiac death (i.e., the defibrillator) was first published in 1970 by Mirowski and Mower. The first reports of CIED-mediated tricuspid valve apparatus interference surfaced in the late 1900s, but it was not until recently that concentrated efforts have been made to better define the scope of CIED-mediated interference with the tricuspid valve apparatus. Because stopping implantation of these devices is not an option, better understanding of their mechanical complications could potentially lead to improvements in device design or epicardial device implantation, as an alternative, in select patients. This review covers existing evidence for CIED-mediated tricuspid regurgitation, discusses potential mechanisms of CIED-mediated interference of the tricuspid valve apparatus, provides an overview of how to diagnose CIED-mediated interference on echocardiography, and discusses management strategies for patients who have CIED-mediated severe tricuspid regurgitation.
Dr. Kapadia has stock options with Navigate Valve. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 15, 2018.
- Revision received September 4, 2018.
- Accepted September 6, 2018.
- 2019 American College of Cardiology Foundation
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