Identification of Pacemaker Lead Position Using Fluoroscopy to Avoid Significant Tricuspid Regurgitation

Permanent pacemaker implantation improves survival but can cause tricuspid valve dysfunction in the form of regurgitation (TR). The dominant mechanism pacemaker-mediated TR is lead impingement. This study evaluated association between location leads crossing and incidence worsening impingement using fluoroscopy. Lead positions were perpendicular right anterior oblique (RAO) parallel left (LAO) fluoroscopic angulation views annulus. A two-dimensional transthoracic echocardiogram (TTE) was performed to evaluate maximum jet area-to-right atrium ratio define severity. three-dimensional TTE observed 23 82 subjects. Most had an inferior position RAO view a septal LAO view. mid risk factors for Mid associated with higher risks significant high TR. Pacemaker-mediated remains problem after implantation.