Tricuspid insufficiency after cardiac-implantable electronic device placement

Figures & data

Table 1. Baseline and follow-up characteristics

Characteristics (Chronic)
Age; mean ± SD	59.86 ± 12.03
Females; n (%)	43 (26.06%)
Co-morbid conditions n (%)
Hypertension	77 (46.67)
Ischemic Heart Disease	73 (44.20)
Chronic Kidney Disease	15 (9.13)
Smokers	54 (32.70)
Characteristics (Clinical)	Baseline	1-year follow-up
Severity of TR; n (%)
None (0)	140 (84.80)	50 (30.30)
Mild (1+)	25 (15.20)	46 (27.90)
Moderate (2+)	0 (0.00)	40 (24.20)
Severe (3+)	0 (0.00)	29 (17.60)
LA volume (Mean±S.D)	27.16 ± 7.57	30.81 ± 15.91
RA volume (Mean±S.D)	25.86 ± 3.15	31.07 ± 6.30
Annular tricuspid diameter (Mean±S.D; cm)	25.71 ± 2.98	27.32 ± 4.11
LVEF (Mean±S.D; %)	37.24 ± 14.55	33.09 ± 14.21
Vena contracta width (Mean±S.D; cm)	0.07 ± 0.01	0.45 ± 0.20

TR-tricuspid regurgitation, LA-left atrium, RA-right atrium, LVEF-left ventricular ejection fraction, SD-standard deviation, n-frequency.

Table 2. Devices used and their indications

Indications	Devices
	DDDR (n, %)	VVIR (n, %)	ICD (n, %)	CRT (n, %)
AV block	128 (77.58)	14 (8.48)	0 (0.00)	0 (0.00)
Scar VT	1 (0.61)	0 (0.00)	5 (3.03)	0 (0.00)
Heart Failure	0 (0.00)	0 (0.00)	0 (0.00)	5 (3.03)
Ischemic VT	0 (0.00)	0 (0.00)	12 (7.27)	0 (0.00)

DDDR- dual-chamber, rate-modulated pacemaker, VVIR- single chamber pacemaker, ICD- implantable cardioverter defibrillator, CRT- cardiac resynchronization device, n-frequency.

Table 3. Left ventricular ejection fraction and tricuspid regurgitation across devices

Device	LVEF			TR
	Baseline LVEF (Mean±S.D)	1-year follow-up LVEF (Mean±S.D)	p-value	Baseline vena contracta (Mean±S.D)	1-year follow-up vena contracta (Mean±S.D)	p-value
DDDR	37.87 ± 15.04	33.91 ± 14.37	0.03	0.08 ± 0.03	0.45 ± 0.20	<0.05
VVIR	35.36 ± 12.48	27.86 ± 14.10	0.15	0.00 ± 0.00	0.51 ± 0.17	<0.05
ICD	36.47 ± 12.47	32.35 ± 13.00	0.35	0.09 ± 0.02	0.48 ± 0.21	<0.05
CRT	29.00 ± 14.32	27.50 ± 13.52	0.87	0.20 ± 0.10	0.30 ± 0.17	0.29

DDDR- dual-chamber, rate-modulated pacemaker, VVIR- single chamber pacemaker, ICD- implantable cardioverter defibrillator, CRT- cardiac resynchronization device, LVEF-left ventricular ejection fraction, TR- tricuspid regurgitation, S.D.-standard deviation.

Table 4. LAVI, RAVI and tricuspid annular diameter across devices

Parameter	Device	Baseline (Mean±S.D)	1-year followup (Mean±S.D)	p-value
LAVI	DDDR	25.26 ± 4.29	29.24 ± 16.76	<0.05
	VVIR	47.57 ± 3.23	48.50 ± 2.77	0.40
	ICD	24.47 ± 4.80	27.41 ± 5.28	0.09
	CRT	28.20 ± 5.54	33.40 ± 4.56	0.14
RAVI	DDDR	26.04 ± 3.04	31.14 ± 6.23	<0.05
	VVIR	24.71 ± 2.40	32.14 ± 6.89	<0.05
	ICD	25.06 ± 3.05	30.47 ± 7.05	<0.05
	CRT	27.20 ± 3.56	28.40 ± 4.39	0.65
Tricuspid annular diameter (cm)	DDDR	25.46 ± 2.92	26.95 ± 4.17	<0.05
	VVIR	26.57 ± 3.18	27.86 ± 3.94	0.33
	ICD	26.82 ± 3.45	29.63 ± 3.74	<0.05
	CRT	27.00 ± 2.12	27.80 ± 1.64	0.52

LA-left atrial volume index, RA-right atrial volume index, DDDR- dual-chamber, rate-modulated pacemaker, VVIR- single chamber pacemaker, ICD- implantable cardioverter defibrillator, CRT- cardiac resynchronization device, S.D.-standard deviation.

Table 5. Regression analysis

Variables	Adjusted Estimates			Unadjusted estimates
	Risk	95% CI	p-value	Risk	95% CI	p-value
Age	0.99	0.97–1.02	0.68	1.00	0.97–1.03	0.94
Gender	1.37	0.65–2.88	0.41	1.04	0.45–2.42	0.93
Type 2 Diabetes Mellitus	1.58	0.80–3.15	0.18	2.11	0.99–4.51	0.54
Hypertension	1.70	0.79–3.62	0.17	2.15	0.91–5.10	0.08
Chronic Kidney Disease	0.48	0.17–1.33	0.16	0.33	0.10–1.09	0.06
Ischemic heart disease	1.21	0.62–2.37	0.58	1.18	0.56–2.48	0.67
Smoking	0.89	0.44–1.08	0.75	1.01	0.44–2.29	0.99
Baseline AF	0.43	0.13–1.51	0.19	0.72	0.11–4.99	0.74
Baseline LVEF	1.06	1.03–1.09	0.00	1.05	1.03–1.09	0.00
Baseline TR	7.37	2.59–20.95	0.00	3.26	0.95–10.99	0.06
Baseline LAVI	0.98	0.94–1.02	0.27	0.99	0.93–1.06	0.73
Baseline tricuspid annular diameter	0.96	0.86–1.07	0.47	0.97	0.85–1.09	0.58

AF-atrial fibrillation, LVEF-left ventricular ejection fraction, TR-tricuspid regurgitation, LA-left atrial volume index.