TCT-169 Safety of Transcatheter Tricuspid Valve Replacement in Patients With Pacemaker Leads
Recommended Citation
Nguyen F, Gandolfo C, Rangavajla G, Giustino G, Fang J, Ilg K, Wyman J, O’Neill W, Engel Gonzalez P, Villablanca P, Lee J, Frisoli T, O’Neill B. TCT-169 Safety of Transcatheter Tricuspid Valve Replacement in Patients With Pacemaker Leads. J Am Coll Cardiol 2024; 84(18):B419.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: With recent approval of the EVOQUE valve, transcatheter tricuspid valve replacement (TTVR) has emerged as an effective therapy for severe tricuspid regurgitation (TR). Many patients undergoing TTVR have existing permanent pacemaker (PPM) or implantable cardiac defibrillator (ICD) leads. The impact of TTVR on impedance and thresholds in these patients is unknown. Methods: Patients with PPM/ICDs undergoing TTVR with the commercial EVOQUE valve at Henry Ford Hospital from February-June 2024 were included. Device interrogations were performed before EVOQUE implant, 24 h after, and at 30 days. Lead position pre- and post-EVOQUE was evaluated by review of cine images. Results: Twelve patients with devices who underwent EVOQUE were included. Mean age was 84 years old. Mean New York Heart Association functional class was 2.8 ± 0.5. 9 patients (75%) had atrial fibrillation, and all had severe TR. Eleven patients had PPMs and 1 had an ICD. All 12 had RV leads (100%), 11 had right atrial leads (92%), 5 had coronary sinus leads (42%), and 1 had a His lead (8%). Average change in lead impedance post-procedure was −5.9% ± 4.9% at 24 h, all <15% (Figure 1). Seven patients had 30-day follow-up with average impedance change of −3.2% ± 4.8%. Average change in RV capture was threshold −3.5% ± 18%. There were no lead dislodgements or need for lead extraction. Mild TR or better post-TTVR was achieved in 9 patients (75%). [Formula presented] Conclusion: TTVR with the EVOQUE appears to be safe in patients with preexisting PPM/ICD leads, with minimal short-term impact on lead parameters. Follow-up beyond 30 days will be necessary to evaluate the long-term effects in these patients. Categories: STRUCTURAL: Valvular Disease: Tricuspid.
Volume
84
Issue
18
First Page
B419
