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Korean J Med > Volume 86(5); 2014 > Article
The Korean Journal of Medicine 2014;86(5): 577-584.
영구형 심박동기 삽입 후 유의한 삼첨판 역류증 발생의 예측인자
이경진, 김계훈, 임이랑, 박혁진, 이승헌, 김지은, 정형기, 윤현주, 윤남식, 홍영준, 박형욱, 김주한, 안영근, 정명호, 조정관, 박종춘
전남대학교병원 순환기내과
Predictors of the Development of Significant Tricuspid Regurgitation after Permanent Pacemaker Implantation
Kyoung Jin Lee, Kye Hun Kim, Yi Rang Yim, Hyuk Jin Park, Seung Hun Lee, Ji Eun Kim, Hyung Ki Jeong, Hyun Ju Yoon, Nam Sik Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Yongkeun Ahn, Myung Jeong, Jeong Gwan Cho, Jong Chun Park
Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
Corresponding Author: Kye Hun Kim ,Tel: +82-62-220-6269, Fax: +82-62-225-6260, Email: christiankyehun@hanmail.net
Received: March 7, 2013;   Revised: March 26, 2013;   Accepted: June 18, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
We sought to identify predictors of significant tricuspid regurgitation (TR) after successful permanent pacemaker (PPM) implantation in Korean patients.

Of 404 patients who underwent PPM implantation, 187 patients who had both baseline and follow-up echocardiographic examinations were assigned to one of two groups: no development or change in TR (Group I, n = 172, 65.5 ± 13.7 years) versus the development of significant TR (Group II, n = 15, 72.1 ± 8.3 years). Clinical, laboratory, and echocardiographic variables were compared between the two groups.

Overall, the grade of TR was significantly aggravated from 0.46 ± 0.73 to 0.81 ± 0.84 (p < 0.001) during 3.1 ± 1.8 years of follow-up (0.49 ± 0.75 to 0.69 ± 0.74 in Group I, p < 0.001; 0.13 ± 0.35 to 2.27 ± 0.46 in Group II, p < 0.001). The de novo development or aggravation of TR was observed in 66 patients (35.3%), and significant TR developed in 15 patients (8.0%). The presence of atrial fibrillation (AF) was significantly higher (53.3 vs. 18.6%, p = 0.002), and the implantation of a ventricle pacing, ventricle sensing, inhibited by ventricular event (VVI) type pacemaker was more frequent in Group II than in Group I (46.7 vs. 15.1%, p = 0.002). Other variables were not different between the groups.

The development or aggravation of TR was not rare after successful PPM implantation, even though the development of significant TR was uncommon. The presence of AF and the implantation of a VVI type pacemaker were predictors of the development of significant TR. Together, the results of this study suggest that the development or aggravation of TR should be monitored carefully after PPM implantation. (Korean J Med 2014;86:577-584)
Keywords: Pacemaker; Tricuspid valve insufficiency; Atrial fibrillation
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