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Hongquan Lu

Hongquan Lu

PLA General Hospital, China

Title: Echocardiography guided right ventricular pacing lead tension adjustion decreses longterm tricuspid insufficency

Biography

Biography: Hongquan Lu

Abstract

Objective: Evaluate the real-time tension adjusting to right ventricular pacing lead guided by transthoretic echocardiography during implantation procedure to the influence of long-term tricuspid insufficiency (TI).

Methods: Consecutive patients with following criteria were screened into the study:

1) Chronic three degree atriventricular conduction block. 2) Dual chamber pacemaker was intended to implant. 3) Without tricuspid insufficiency before procedure. 4) Right Passive fixarion ventricular lead from Medtronic Company could be used. Enrolled patients were randomized into TAF group (tension adjusting by fluorospy) and TAE group (tension adjusting by fluorospy plus echocardiography). All passive leads were fixed at right ventricular apex. After satisfied parameter measurement, Trans tricuspid lead tension was adjusted by fluorospy only in TAF group and by fluorospy plus echocardiography. In TAE group, lead tension was adjusten by fluorosoy at first. Then echocardiography was conducted to exam possible tricuspid insufficiency or valvular deformation until adjusting satisfaction. All patients were following up more than 12 months by regular echocardiography.

Results: Total 76 patients (63.8+－11.5 yrs, male 43) were enrolled. Thirty seven cases were randomized into TAF group (64.3+-9.6 yrs, male 21) and 39 cases into TAE group (62.9+-10.7 yrs, male 22). All procedures were successful without complications. In TAE group, mild to moderate TI were detected and rectified after primary floroscopy tension adjusting in 12 patients (30.8%). In TAF group, mild to moderate TI was detected within 24 hours after procedure in 9 patients (24.3%) and it was kept to the end of follow up. During the follow up of 17.5+－4.8 months, TI in TAE group was significantly less than that in TAF group (0.5% vs 24.3%, P<0.01).

Conclusions Echocardiography guided right ventricular pacing lead tension adjusting significantly decreases acute and long-term mild to moderate tricuspid insufficiency.