Universität zu Köln

Wrobel, Jan M. ORCID: 0000-0002-1637-3413, Kirchner, Johannes, Friedrichs, Kai, Gietzen, Thorsten ORCID: 0000-0001-7948-202X, Althoff, Jan ORCID: 0000-0001-9390-0160, Hasse, Caroline ORCID: 0000-0001-9757-1843, von Stein, Philipp ORCID: 0000-0003-4548-3897, Wörmann, Jonas ORCID: 0000-0002-2213-8946, von Stein, Jennifer ORCID: 0009-0000-3871-164X, Curio, Jonathan ORCID: 0000-0002-3437-7450, Rudolph, Felix, Ivannikova, Maria, Iliadis, Christos ORCID: 0000-0001-7655-8500, Steven, Daniel ORCID: 0000-0001-6839-5895, Baldus, Stephan ORCID: 0000-0001-8259-1737, Rudolph, Volker, Pfister, Roman ORCID: 0000-0002-4358-5008, Gerçek, Muhammed and Koerber, Maria I. ORCID: 0000-0001-9073-9279 (2025). Cardiac implantable electronic device carriers undergoing transcatheter tricuspid valve annuloplasty: real-world insights. Clinical Research in Cardiology, 114 (7). pp. 878-891. Springer Nature. ISSN 1861-0684

PDF s00392-025-02616-5.pdf Bereitstellung unter der CC-Lizenz: Creative Commons Attribution. Download (978kB)

Abstract

Background: Transtricuspid cardiac implantable electronic devices (CIEDs) complicate the management of tricuspid regurgitation (TR). Transcatheter tricuspid valve annuloplasty (TTVA) offers a promising approach due to minimal interaction with leaflets and transvalvular CIEDs, though real-world evidence is limited. Methods: This bi-center, retrospective study includes 204 consecutive patients who underwent TTVA with the Cardioband (Edwards Lifesciences) for severe symptomatic TR. Patients were divided into CIED carriers and non-CIED carriers. CIED carriers were further classified into those with lead-associated TR (LTR-A) and those with TR unrelated to CIED leads (LTR-B). Results: Among the 204 patients, 41 (20%) were CIED carriers. Of these, 24% had mixed TR etiology (functional and LTR-A), while 76% had predominantly functional TR (LTR-B). Compared to non-CIED-carriers, CIED carriers were more symptomatic (NYHA-FC > II; 93% vs. 89%; p = 0.026) with comparable TR severity at baseline. Intraprocedural success according to the Tricuspid Valve Academic Research Consortium was 68% in CIED carriers and 70% in non-CIED carriers ( p = 0.851). LTR-A was associated with poorer TR reduction immediately after TTVA ( p = 0.022). Overall safety was comparable, with right ventricular lead dislodgement occurring in one patient. Beyond that, CIED function remained unimpaired. At 30 days, echocardiographic follow-up showed comparable TR reduction (TR ≤ II: 56% vs. 68%; p = 0.219) and NYHA-FU ≤ II (63% vs. 70%; p = 0.524) in CIED-and non-CIED carriers, respectively. Conclusions: TTVA achieves significant TR reduction, providing a safe and effective therapeutic option for TR treatment in CIED carriers. What is known? TTVA using the Cardioband has been approved for severe, symptomatic TR patients, however data on the safety and efficacy in CIED carriers is lacking. What the study adds? Intraprocedural success and safety were comparable in CIED and non-CIED carriers treated with TTVA. Subgroup analyses showed a trend towards worse outcome and efficiency of TTVA in patients with LTR-A. Postinterventional CIED interrogations did not show critical technical issues. Graphical abstract: Intraprocedural success and TR reduction following TTVA in CIED- and non-CIED-carriers. Blue arrows indicate CIED lead trajectory through tricuspid valve. BL Baseline, FU = 30-day Follow Up, LTR-A Lead-associated Tricuspid Regurgitation, type A, LTR-B Lead-associated Tricuspid Regurgitation, type B, TR Tricuspid Regurgitation, TTVA Transcatheter Tricuspid Valve Annuloplasty

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Wrobel, Jan M. UNSPECIFIED https://orcid.org/0000-0002-1637-3413 UNSPECIFIED Kirchner, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Gietzen, Thorsten UNSPECIFIED https://orcid.org/0000-0001-7948-202X UNSPECIFIED Althoff, Jan UNSPECIFIED https://orcid.org/0000-0001-9390-0160 UNSPECIFIED Hasse, Caroline UNSPECIFIED https://orcid.org/0000-0001-9757-1843 UNSPECIFIED von Stein, Philipp UNSPECIFIED https://orcid.org/0000-0003-4548-3897 UNSPECIFIED Wörmann, Jonas UNSPECIFIED https://orcid.org/0000-0002-2213-8946 UNSPECIFIED von Stein, Jennifer UNSPECIFIED https://orcid.org/0009-0000-3871-164X UNSPECIFIED Curio, Jonathan UNSPECIFIED https://orcid.org/0000-0002-3437-7450 UNSPECIFIED Rudolph, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Ivannikova, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED https://orcid.org/0000-0001-7655-8500 UNSPECIFIED Steven, Daniel UNSPECIFIED https://orcid.org/0000-0001-6839-5895 UNSPECIFIED Baldus, Stephan UNSPECIFIED https://orcid.org/0000-0001-8259-1737 UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED https://orcid.org/0000-0002-4358-5008 UNSPECIFIED Gerçek, Muhammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Maria I. UNSPECIFIED https://orcid.org/0000-0001-9073-9279 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-797747
Identification Number:	10.1007/s00392-025-02616-5
Journal or Publication Title:	Clinical Research in Cardiology
Volume:	114
Number:	7
Page Range:	pp. 878-891
Number of Pages:	14
Date:	10 July 2025
Publisher:	Springer Nature
ISSN:	1861-0684
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79774