Significant mitral regurgitation after permanent right ventricular pacemaker implantation : prognostic implications




Nabeta Takeru, Galloo Xavier, Tops Laurens, Stassen Jan, Marsan Nina Ajmone, van der Bijl Pieter, Bax Jeroen J

PublisherElsevier

2024

American Journal of Cardiology

The American Journal of Cardiology

222

78

86

0002-9149

1879-1913

DOIhttps://doi.org/10.1016/j.amjcard.2024.05.003

https://doi.org/10.1016/j.amjcard.2024.05.003



The underlying mechanisms leading to the development of mitral regurgitation (MR) after right ventricular (RV) pacemaker (PM) implantation and its prognostic value have yet to be fully understood. The purpose of this study was to evaluate the prevalence and clinical variables associated with the development of MR after RV pacing and its association with outcomes. A total of 451 patients (mean age 69 ± 15 years, 61% male) who underwent de novo RV PM implantation were included. The development of significant MR, defined as ≥ moderate from mild or none/trace at baseline, occurred in 131 (29%) patients at a median of 2.4 years [interquartile range (IQR): 1.0-3.8 years] after PM implantation. Multivariate logistic regression analysis demonstrated that implantation of a single-chamber PM, LV end-systolic volume index and the presence of mild MR (vs no MR) at baseline were independently associated with the development of significant MR post-implant. Cardiac events, defined as the composite of all-cause mortality or heart failure hospitalization, occurred in 143 patients (31.7%) during a median follow-up of 5.4 years [IQR: 3.0-8.1 years]. Multivariate Cox regression analysis demonstrated that the development of significant MR was independently related to the occurrence of cardiac events. In conclusion, the development of significant MR after PM implantation is seen in about one third of recipients and is independently associated with adverse cardiac events.



The Department of Cardiology (Leiden University Medical Center) received research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare (Little Chalfont, United Kingdom) , Medtronic, and Novartis. Jan Stassen received funding from the European Society of Cardiology (Brussel, Belgium) , Training Grant App000064741.


Last updated on 2024-28-11 at 12:16