Background: Tricuspid regurgitation (TR) was reported to develop following permanent pacemaker implantation (PPMI). However, the impact of time on the incidence and progression of TR has not been fully elucidated.
Methods: Patients (pts) with first PPMI had serial echo studies: 0), 1), and >1-year after PPMI (T2). TR was graded as none, mild, moderate and severe by conventional echo criteria. Only pts with none/mild TR at baseline were included. Pts after tricuspid or mitral valve surgery were excluded.
Results: Total of 112 pts (age 72±10 yrs, 45 women) were studied. Significant TR was detected in 25% within 6 mo and in 49% after a year post PPMI (Figure, p<0.001). In 10 pts the TR worsening already appeared during the first month after PPMI. Mean peak TR gradient increased from 28.0±9.1 mmHg at T0 to 30.8±11.7 at T1 and to 32.5±13.5 mmHg at T2 (p=0.01). Multivariate logistic regression analysis (adjusted for age >75 yrs, gender, atrial fibrillation, CHF on admission, ICD, TR gradient, left atrial diameter) revealed that time from PPMI was the only significant clinical variable associated with TR progression (T0 to T1: OR 1.38, p=0.08; T1 to T2: OR=1.23, p=0.009).
Conclusions: Serial echo studies before and after PPMI revealed that:
(1) PPMI is associated with the development of TR; (2) TR development after PPM is time related - incidence and severity increased over time independent of other factors.
