Pulse Brain · Growing Health Evidence Index
Tier 4 — Narrative / commentaryPeer-reviewed

Lead management in patients undergoing percutaneous tricuspid valve replacement or repair: a ‘heart team’ approach

James Gabriels, Robert D. Schaller, Elana Koss, Bruce Rutkin, Roger G. Carrillo, Laurence M. Epstein

EP Europace · 2023

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Summary

This state-of-the-art review addresses the clinical management of tricuspid regurgitation in patients with cardiac implantable electronic devices, focusing on the emerging use of percutaneous transcatheter valve replacement and repair. The authors highlight that transvascular lead extraction decisions require multidisciplinary consideration, as extraction may both improve and worsen regurgitation severity, and advocate for including a lead management specialist within the heart team to optimise patient outcomes and minimise procedural complications.

UK applicability

The clinical guidance on multidisciplinary decision-making for CIED lead management in transcatheter valve procedures would be applicable to UK cardiology and electrophysiology services, though specific implementation may depend on local access to lead extraction expertise and interventional capacity.

Key measures

Tricuspid regurgitation severity; lead-valve apparatus interactions; transvascular lead extraction outcomes; jailing complications (lead fracture, infection risk)

Outcomes reported

The review discusses management strategies and clinical decision-making for patients with cardiac implantable electronic devices (CIEDs) and tricuspid regurgitation undergoing percutaneous tricuspid valve intervention. It examines the role of transvascular lead extraction in modifying tricuspid regurgitation severity and reducing procedural risks.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Narrative Review
Study design
Narrative review
Source type
Peer-reviewed study
Status
Published
System type
Human clinical
DOI
10.1093/europace/euad300
Catalogue ID
SNmojj1l1c-h1yh6l

Topic tags

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