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Implantation of leadless pacing systems in patients early after tricuspid valve surgery: A feasible option
Author(s) -
Theis Cathrin,
Huber Carola,
Kaesemann Philipp,
Kaiser Bastian,
Heinrich Hannah,
Albert Marc,
Nagib Ragi,
Franke Ulrich F. W.,
Bekeredjian Raffi
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14069
Subject(s) - medicine , fluoroscopy , atrial fibrillation , tricuspid valve , regurgitation (circulation) , surgery , cardiology , concomitant , heart block , permanent pacemaker , implant , electrocardiography
Background After tricuspid valve (TV) surgery due to tricuspid regurgitation (TR), patients needing a permanent pacemaker often receive an epicardial lead implantation. This may result in delayed recovery from open‐chest surgery and increased postoperative risk. Leadless pacemaker (LPM) implantation may represent a valuable option. Methods and Results A total of 14 consecutive patients underwent LPM implantation (Micra Transcatheter Pacing System, Medtronic, Minneapolis, MN) early after TV surgery. The pacing indication in those patients was atrial fibrillation with a slow atrio‐ventricular (AV) conduction or atrial fibrillation and a concomitant AV block III. Three patients already had a pacemaker prior to surgery, which was explanted during TV repair. Three patients received a valve replacement with a bioprosthesis, while the remaining eight patients received a TV repair. All procedural data and device measurements during and after LPM implantation were recorded. Transthoracic echocardiography was performed prior and post LPM implantation, showing no changes in TV or bioprosthesis performance. The device measurements were within an adequate range: threshold: 0.83 ± 0.34 V @ 0.24 ± 0 ms, impedance: 480 ± 58.88 ohm, and R‐wave: 10.10 ± 3.60 mV. LPM implantation was successful in all patients with a mean procedural time of 32 ± 11.8 minutes, fluoroscopy time of 3.71 ± 3.15 minutes, and dose‐area product of 536.67 ± 811.26 cGy/m 2 . Conclusions Implantation of an LPM early after TV surgery is a feasible option. LPM implantation does not affect TV or bioprosthesis performance in transthoracic echocardiography.