| Pacemaker-Related Tricuspid Regurgitation: An Uninvited Menace of an Invited Guest |
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Jun-Bean Park, Yong-Jin Kim |
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Department of Internal Medicine, Seoul National University College of Medicine; Cardiovascular Center, Seoul National University Hospital, Seoul, Korea |
| 심박동기로 인한 삼첨판 역류: 초대받은 손님, 초대받지 못한 합병증 |
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박준빈, 김용진 |
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서울대학교 의과대학 내과학교실, 서울대학교병원 심혈관센터 |
Correspondence:
Yong-Jin Kim, Tel: +82-2-2072-1963, Fax: +82-2-2072-4922, Email: kimdamas@snu.ac.kr
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| 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. |
| Abstract |
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A permanent pacemaker is a mainstay treatment for symptomatic bradyarrhythmia, including atrioventricular node blocks and sick sinus syndrome. Although this device was introduced to aid electrical recovery, pacemakers can cause mechanical dysfunction of the tricuspid valve, resulting in significant tricuspid regurgitation (TR). Because pacemaker-related TR is a correctable cause of right heart failure, it is of paramount importance to assess the presence or severity of TR and its association with pacemakers. However, acoustic shadowing from the pacemaker wire hampers the accurate visualization of TR jets, and increases the risk of failing to detect severe TR. Accordingly, goal-directed imaging with a high index of clinical suspicion should be performed when patients present with right heart failure after pacemaker implantation. In this issue of the Journal, the authors sought to investigate the frequency of aggravated TR in patients after pacemaker implantation. They also explored the predictors of TR aggravation, which might provide valuable information for identification of patients who require meticulous follow-up to allow timely intervention. These data regarding the predictive variables for pacemaker-related TR can serve as a roadmap for future studies to identify strategies for reducing the risk of significant TR, such as a tailored approach based on heart rhythm (bradyarrhythmia only vs. combined atrial fibrillation), pacemaker mode (VVI vs. DDD), the location of the pacemaker lead (apical vs. base), and the use of state-of-the art techniques (classical lead vs. leadless). (Korean J Med 2014;86:573-576) |
| Key Words:
Pacemaker; Tricuspid regurgitation |
| 주제어:
심박동기; 삼첨판 역류 |
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