Do the longer leadless pacemakers with helix screws affect tricuspid regurgitation after pacemaker implantation?

Leadless pacemakers (LPs) with flexible tines have been reported not to worsen tricuspid regurgitation (TR) than transvenous pacemakers after pacemaker implantation (PMI). Other longer LPs with helix screws have recently become available.

To clarify whether the longer LPs with helix screws affect tricuspid regurgitation after pacemaker implantation compared with flexible times LPs and transvenous pacemakers.

Sixty patients who underwent PMI were studied (34 males, 82±8 years, 29 trans-venous pacemakers,17 LPs with flexible tines, and 14 LPs with helix screws). Clinical data and blood samples were obtained before PMI. Transthoracic echocardiography was performed before and 1 week after PMI to assess conventional echocardiographic parameters and severity of TR by quantitative assessment.

The TR effective regurgitant orifice area (EROA) decreased post-PMI in LPs with flexible tines (p=0.0030) and LPs with helix screws (p=0.0337), but not in the transvenous pacemakers (p=0.5057). The TR volume decreased post-PMI in LPs with flexible tines (p=0.0159) and LPs with helix screws (p=0.0334), but not in transvenous pacemakers (p=0.8467). The change in TR EROA was greater in LPs with flexible tines compared to LPs with helix screws and transvenous pacemakers (p=0.0147). One patient implanted with LPs with helix screws showed frequent premature ventricular contractions after PMI.

The longer LPs with helix screws might affect TR, unlike LPs with flexible tines.