Incidence of new-onset severe tricuspid regurgitation after implantation of pacemaker

Abstract Abstract Pacemaker-induced tricuspid regurgitation has been established as an entity that can impact on the morbidity and mortality of patients receiving a pacemaker. However, a pacemaker is life-saving therapy, and the true incidence of new-onset severe tricuspid regurgitation remains unknown. Purpose To evaluate the incidence of new-onset severe tricuspid regurgitation in patients receiving a pacemaker and the factors associated with the development of severe tricuspid regurgitation. Methods Consecutive patients who received a pacemaker and had at least one echocardiogram within the year preceding the implantation and another one after implantation were included. The primary outcome was new-onset severe tricuspid regurgitation. Baseline clinical and echocardiographic characteristics were analysed to identify potential risk factors for TR worsening. Cox regression model was performed to identify independent predictors of severe TR. Results Of 223 patients (72.9 ± 12.4 years, 61.9% male), 24 patients (10.8%) presented with new severe TR. The mean time to development of severe TR was 34.5±22.3months. Compared with those without severe TR, patients with severe TR were older (78.5 ± 9.1 vs. 72.2 ± 12.5 years, p=0.006), had a higher prevalence of atrial fibrillation (70.8% vs. 39.7%, p=0.004), had higher prevalence of significant mitral regurgitation (33.3% vs. 15.1%, p=0.04) and significant mitral valve stenosis (20.8% vs. 1.0% p