Managing Implanted Cardiac Electronic Devices in Patients With Severe Tricuspid Regurgitation: JACC State-of-the-Art Review,Journal of the American College of Cardiology

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Managing Implanted Cardiac Electronic Devices in Patients With Severe Tricuspid Regurgitation: JACC State-of-the-Art Review
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2024-05-13 , DOI: 10.1016/j.jacc.2024.02.045
Rebecca T Hahn ₁ , Bruce Larry Wilkoff ₂ , Susheel Kodali ₃ , Ulrika Maria Birgersdotter-Green ₄ , Gorav Ailawadi ₅ , Karima Addetia ₆ , Martin Andreas ₇ , Angelo Auricchio ₈ , Frederick Ehlert ₃ , Isaac George ₃ , Aakriti Gupta ₉ , Rachel Harrison ₁₀ , Edwin C Ho ₁₁ , Fred Kusumoto ₁₂ , Azeem Latib ₁₁ , Patrick O'Gara ₁₃ , Kristen K Patton ₁₄ , Sean Pinney ₁₅ , Emily P Zeitler ₁₆ , Michael J Mack ₁₇ , Martin B Leon ₁ , Laurence M Epstein ₁₈ ,

Affiliation

Columbia University Irving Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA.
Cleveland Clinic, Cleveland, Ohio, USA.
Columbia University Irving Medical Center, New York, New York, USA.
University of California-San Diego, San Diego, California, USA.
University of Michigan, Ann Arbor, Michigan, USA.
University of Chicago Medicine, Chicago, Illinois, USA.
MedUni, Vienna, Austria.
Istituto Cardiocentro Ticino, Lugano, Switzerland.
Cedars Sinai Medical Center, Los Angeles, California, USA.
Medstar Health Research Institute, Washington, DC, USA.
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Mayo Clinic, Jacksonville, Florida, USA.
Brigham & Women's Hospital, Boston, Massachusetts, USA.
U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Dartmouth Health, Lebanon, New Hampshire, USA.
Baylor Scott & White Health, Dallas, Texas, USA.
Northwell Health, New York, New York, USA.

Orthotopic transcatheter tricuspid valve replacement (TTVR) devices have been shown to be highly effective in reducing tricuspid regurgitation (TR), and interest in this therapy is growing with the recent commercial approval of the first orthotopic TTVR. Recent TTVR studies report preexisting cardiac implantable electronic device (CIED) transvalvular leads in ∼35% of patients, with entrapment during valve implantation. Concerns have been raised regarding the safety of entrapping leads and counterbalanced against the risks of transvenous lead extraction (TLE) when indicated. This Heart Valve Collaboratory consensus document attempts to define the patient population with CIED lead-associated or lead-induced TR, describe the risks of lead entrapment during TTVR, delineate the risks and benefits of TLE in this setting, and develop a management algorithm for patients considered for TTVR. An electrophysiologist experienced in CIED management should be part of the multidisciplinary heart team and involved in shared decision making.

中文翻译：

管理严重三尖瓣反流患者植入的心脏电子设备：JACC 最先进的审查

原位经导管三尖瓣置换 (TTVR) 装置已被证明在减少三尖瓣反流 (TR) 方面非常有效，并且随着首个原位 TTVR 最近获得商业批准，人们对这种疗法的兴趣与日俱增。最近的 TTVR 研究报告称，约 35% 的患者先前存在心脏植入式电子设备 (CIED) 跨瓣膜引线，在瓣膜植入过程中出现卡压。人们对截留导线的安全性提出了担忧，并在有需要时抵消了经静脉导线抽取 (TLE) 的风险。这份心脏瓣膜合作共识文件试图定义 CIED 铅相关或铅诱导 TR 的患者群体，描述 TTVR 期间铅滞留的风险，描述在此情况下 TLE 的风险和益处，并为患者开发管理算法考虑用于 TTVR。在 CIED 管理方面经验丰富的电生理学家应该成为多学科心脏团队的一部分，并参与共同决策。

更新日期：2024-05-13

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