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Echocardiographic assessment of tricuspid regurgitation and pericardial effusion after cardiac device implantation.

Abstract

BACKGROUND

The frequency of cardiac implantable electronic device (CIED) implantations is constantly increasing. Pericardial effusion (PE) and tricuspid regurgitation (TR) may occur after CIED implantation. The aim of the present study is to evaluate the prevalence and risk factors for new occurrences or progression of TR and PE early after CIED implantation.

METHODS

This is an on-going, single-center, observational study of patients after their first CIED implantation, with an echocardiographic evaluation within 60 days before and 7 days after the procedure. Data are presented for first 110 consecutive patients who underwent CIED implantation from August 2015 to July 2016.

RESULTS

Median age was 75 years, and 44% were women. In total, 87 (79%) pacemakers, 21 (19%) implantable cardioverter-defibrillators and 2 cardiac resynchronization therapy devices were implanted. After CIED implantation, there was TR progression in 17 (16%) patients: 5 patients developed moderate TR, none developed severe TR. An increase in TR was more often observed after implantations performed by operators in training than by certified operators (35% vs. 12%, p = 0.02). New PE after the procedure was observed in 8 (7%) patients and was trivial (< 5 mm) in all cases. Patients with new PE after implantation had lower baseline hemoglobin levels and tended to be women.

CONCLUSIONS

New PE and an increase in TR severity are rare complications early after CIED implantation. Operator experience might be related to TR progression. Increasing the number of patients in the current on-going study will allow a more reliable assessment of the prevalence and risk factors of these complications.

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  • Authors+Show Affiliations

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland. agnieszka.kaplon-cieslicka@wum.edu.pl.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    ,

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

    Source

    Cardiology journal : 2019 06 21 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31225634

    Citation

    Jabłońska, Katarzyna, et al. "Echocardiographic Assessment of Tricuspid Regurgitation and Pericardial Effusion After Cardiac Device Implantation." Cardiology Journal, 2019.
    Jabłońska K, Wiechecki B, Kapłon-Cieślicka A, et al. Echocardiographic assessment of tricuspid regurgitation and pericardial effusion after cardiac device implantation. Cardiol J. 2019.
    Jabłońska, K., Wiechecki, B., Kapłon-Cieślicka, A., Tymińska, A., Budnik, M., Hołowaty, D., ... Opolski, G. (2019). Echocardiographic assessment of tricuspid regurgitation and pericardial effusion after cardiac device implantation. Cardiology Journal, doi:10.5603/CJ.a2019.0053.
    Jabłońska K, et al. Echocardiographic Assessment of Tricuspid Regurgitation and Pericardial Effusion After Cardiac Device Implantation. Cardiol J. 2019 06 21; PubMed PMID: 31225634.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Echocardiographic assessment of tricuspid regurgitation and pericardial effusion after cardiac device implantation. AU - Jabłońska,Katarzyna, AU - Wiechecki,Bartosz, AU - Kapłon-Cieślicka,Agnieszka, AU - Tymińska,Agata, AU - Budnik,Monika, AU - Hołowaty,Dominika, AU - Jakubowski,Krzysztof, AU - Michalak,Marcin, AU - Świętoń,Elżbieta, AU - Stolarz,Przemysław, AU - Steckiewicz,Roman, AU - Grabowski,Marcin, AU - Scisło,Piotr, AU - Kochanowski,Janusz, AU - Filipiak,Krzysztof J, AU - Opolski,Grzegorz, Y1 - 2019/06/21/ PY - 2018/10/28/received PY - 2019/03/31/accepted PY - 2019/03/24/revised PY - 2019/6/22/entrez PY - 2019/6/22/pubmed PY - 2019/6/22/medline KW - cardiac implantable electronic device KW - complications KW - implantable cardioverter-defibrillator KW - pacemaker JF - Cardiology journal JO - Cardiol J N2 - BACKGROUND: The frequency of cardiac implantable electronic device (CIED) implantations is constantly increasing. Pericardial effusion (PE) and tricuspid regurgitation (TR) may occur after CIED implantation. The aim of the present study is to evaluate the prevalence and risk factors for new occurrences or progression of TR and PE early after CIED implantation. METHODS: This is an on-going, single-center, observational study of patients after their first CIED implantation, with an echocardiographic evaluation within 60 days before and 7 days after the procedure. Data are presented for first 110 consecutive patients who underwent CIED implantation from August 2015 to July 2016. RESULTS: Median age was 75 years, and 44% were women. In total, 87 (79%) pacemakers, 21 (19%) implantable cardioverter-defibrillators and 2 cardiac resynchronization therapy devices were implanted. After CIED implantation, there was TR progression in 17 (16%) patients: 5 patients developed moderate TR, none developed severe TR. An increase in TR was more often observed after implantations performed by operators in training than by certified operators (35% vs. 12%, p = 0.02). New PE after the procedure was observed in 8 (7%) patients and was trivial (< 5 mm) in all cases. Patients with new PE after implantation had lower baseline hemoglobin levels and tended to be women. CONCLUSIONS: New PE and an increase in TR severity are rare complications early after CIED implantation. Operator experience might be related to TR progression. Increasing the number of patients in the current on-going study will allow a more reliable assessment of the prevalence and risk factors of these complications. SN - 1897-5593 UR - https://www.unboundmedicine.com/medline/citation/31225634/Echocardiographic_assessment_of_tricuspid_regurgitation_and_pericardial_effusion_after_cardiac_device_implantation L2 - http://dx.doi.org/10.5603/CJ.a2019.0053 DB - PRIME DP - Unbound Medicine ER -